Canadian Community Health Survey (CCHS) - 2019

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

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Table of Contents

Proxy interview (GR)

Proxy interview (GR) - Question identifier:GR_N005

Who is providing the information for this person's component?

  • 01: MEMBER1
  • 02: MEMBER2
  • 03: MEMBER3
  • 04: MEMBER4
  • 05: MEMBER5
  • 06: MEMBER6
  • 07: MEMBER7
  • 08: MEMBER8
  • 09: MEMBER9
  • 10: MEMBER10
  • 11: MEMBER11
  • 12: MEMBER12
  • 13: MEMBER13
  • 14: MEMBER14
  • 15: MEMBER15
  • 16: MEMBER16
  • 17: MEMBER17
  • 18: MEMBER18
  • 19: MEMBER19
  • 20: MEMBER20
  • 88: Not a household member

Proxy interview (GR) - Question identifier:GR_N010

Do you want to complete this component by proxy?

  • 1: Yes
  • 2: No

Proxy interview (GR) - Question identifier:GR_N015

Record the reason why this component is being completed by proxy. Proxy interviews are to occur only if the mental or physical health of the selected member makes it impossible to complete the interview during the collection period.

  • 1: Physical health condition
  • 2: Mental health condition

Proxy interview (GR) - Question identifier:GR_N020

Enter the condition.

Long Answer Length = 80

Age of respondent (ANC1)

Age of respondent (ANC1) - Question identifier:ANC1_Q01

What is [Name of specific respondent]'s date of birth?

Min = 1; Max = 31

Age of respondent (ANC1) - Question identifier:ANC1_Q02

What is [Name of specific respondent]'s date of birth?

  • 01: January
  • 02: February
  • 03: March
  • 04: April
  • 05: May
  • 06: June
  • 07: July
  • 08: August
  • 09: September
  • 10: October
  • 11: November
  • 12: December
  • 98: RF
  • 99: DK

Age of respondent (ANC1) - Question identifier:ANC1_Q03

What is [Name of specific respondent]'s date of birth?

Min = 0; Max = 9997

Age of respondent (ANC1) - Question identifier:ANC1_Q04

So [Name of specific respondent]'s age on [Reference system date] was [Age calculated based on the entered date of birth].
Is that correct?

  • 1: Yes
  • 2: No, return and correct date of birth
  • 3: No, collect age

Age of respondent (ANC1) - Question identifier:ANC1_Q05

What is [Name of specific respondent]'s age?

Min = 0; Max = 121

Age of respondent (ANC1) - Question identifier:ANC1_R010

Because you are less than 12 years old, you are not eligible to participate in the Canadian Community Health Survey.

Age of respondent (ANC1) - Question identifier:ANC1_R015

Because you are more than 17 years old, you are not eligible to participate in the Canadian Community Health Survey.

Age of respondent (ANC1) - Question identifier:ANC1_R020

Because you are less than 18 years old, you are not eligible to participate in the Canadian Community Health Survey.

Age of respondent (ANC1) - Question identifier:ANC1_N030

Please confirm the spelling of respondent's first name. Update first name, if necessary.

Original First Name: [First name]
Original Last Name: [Last name]

Long Answer Length = 25

Age of respondent (ANC1) - Question identifier:ANC1_N035

Please confirm the spelling of respondent's last name. Update last name, if necessary.

Original First Name: [First name]
Original Last Name: [Last name]

Long Answer Length = 25

Sex and Gender (GDR)

Sex and Gender (GDR) - Question identifier:GDR_R005

The following questions are about sex at birth and gender. Sex refers to sex assigned at birth. Gender refers to current gender which may be different from sex assigned at birth and may be different from what is indicated on legal documents.

Sex and Gender (GDR) - Question identifier:GDR_Q005

What was your sex at birth?

  • 1: Male
  • 2: Female
  • 8: RF
  • 9: DK

Sex and Gender (GDR) - Question identifier:GDR_Q010

What is your gender?

  • 1: Male
  • 2: Female
  • 3: Or please specify
  • 8: RF
  • 9: DK

Sex and Gender (GDR) - Question identifier:GDR_R020

This survey asks questions based on sex at birth, such as pregnancy experiences and some cancer screening tests. If specific questions are not relevant to you, we can skip those questions. Thank you for your understanding and for your participation.

Relationship without confirmation (RNC)

Relationship without confirmation (RNC) - Question identifier:RNC_Q1

What is the relationship...

of: [Name of specific respondent] ([Age of specific respondent])

to: [Name of secondary respondent] ([Age of secondary respondent])?

  • 01: Husband/wife
  • 02: Common-law partner
  • 03: Father/mother
  • 04: Son/daughter (birth, adopted or step)
  • 05: Brother/sister
  • 06: Foster father/mother
  • 07: Foster son/daughter
  • 08: Grandfather/ grandmother
  • 09: Grandson/ granddaughter
  • 10: In-law
  • 11: Other related
  • 12: Unrelated
  • 98: RF
  • 99: DK

Relationship without confirmation (RNC) - Question identifier:RNC_Q2A

Is that a(n)... ?

  • 1: Birth father/mother
  • 2: Stepfather/stepmother
  • 3: Adoptive father/mother
  • 8: RF
  • 9: DK

Relationship without confirmation (RNC) - Question identifier:RNC_Q2B

Is that a(n)... ?

  • 1: Birth son/daughter
  • 2: Stepson/stepdaughter
  • 3: Adopted son/daughter
  • 8: RF
  • 9: DK

Relationship without confirmation (RNC) - Question identifier:RNC_Q2C

Is that a(n)... ?

  • 1: Full brother/sister
  • 2: Half brother/sister
  • 3: Stepbrother/stepsister
  • 4: Adopted brother/sister
  • 5: Foster brother/sister
  • 8: RF
  • 9: DK

Relationship without confirmation (RNC) - Question identifier:RNC_Q2D

Is that a(n)... ?

  • 1: Father-in-law / mother-in-law
  • 2: Son-in-law / daughter-in-law
  • 3: Brother-in-law / sister-in-law
  • 4: Other in-law
  • 8: RF
  • 9: DK

Relationship without confirmation (RNC) - Question identifier:RNC_Q2E

Is that a(n)... ?

  • 1: Uncle/aunt
  • 2: Cousin
  • 3: Nephew/niece
  • 4: Other relative
  • 8: RF
  • 9: DK

Relationship without confirmation (RNC) - Question identifier:RNC_Q2F

Is that a(n)... ?

  • 1: Boyfriend/girlfriend
  • 2: Roommate/lodger/ boarder
  • 3: Other - Specify
  • 8: RF
  • 9: DK

Main activity (MAC)

Main activity (MAC) - Question identifier:MAC_Q005

Last week, was your main activity working at a paid job or business, looking for paid work, going to school, caring for children, household work, retired or something else?

  • 01: Working at a paid job or business
  • 02: Vacation (from paid work)
  • 03: Looking for paid work
  • 04: Going to school (including vacation from school)
  • 05: Caring for children
  • 06: Household work
  • 07: Retired
  • 08: Maternity/paternity leave
  • 09: Long term illness
  • 10: Volunteering
  • 11: Care-giving other than for children
  • 12: Other
  • 98: RF
  • 99: DK

Main activity (MAC) - Question identifier:MAC_Q010

Have you worked at a job or business at any time in the past 12 months?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Main activity (MAC) - Question identifier:MAC_Q015

Are you currently attending school, college, CEGEP or university?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Main activity (MAC) - Question identifier:MAC_Q020

Are you enrolled as...?

  • 1: A full-time student
  • 2: A part-time student
  • 3: Both full-time and part-time student
  • 8: RF
  • 9: DK

Main activity (MAC) - Question identifier:MAC_Q025

To better understand the information you will provide on your health it is important to know if you are pregnant. Are you pregnant?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

General health (GEN)

General health (GEN) - Question identifier:GEN_R005

The next questions are about your health. By health, we mean not only the absence of disease or injury but also physical, mental and social well-being.

General health (GEN) - Question identifier:GEN_Q005

In general, would you say your health is... ?

  • 1: Excellent
  • 2: Very good
  • 3: Good
  • 4: Fair
  • 5: Poor
  • 8: RF
  • 9: DK

General health (GEN) - Question identifier:GEN_Q010

Using a scale of 0 to 10, where 0 means "Very dissatisfied" and 10 means "Very satisfied", how do you feel about your life as a whole right now?

0 Very dissatisfied
1 I
2 I
3 I
4 I
5 I
6 I
7 I
8 I
9 V
10 Very satisfied

Min = 0; Max = 10

General health (GEN) - Question identifier:GEN_Q015

In general, would you say your mental health is...?

  • 1: Excellent
  • 2: Very good
  • 3: Good
  • 4: Fair
  • 5: Poor
  • 8: RF
  • 9: DK

General health (GEN) - Question identifier:GEN_Q020

Thinking about the amount of stress in your life, would you say that most of your days are...?

  • 1: Not at all stressful
  • 2: Not very stressful
  • 3: A bit stressful
  • 4: Quite a bit stressful
  • 5: Extremely stressful
  • 8: RF
  • 9: DK

General health (GEN) - Question identifier:GEN_R025

The next question is about your main job or business in the past 12 months.

General health (GEN) - Question identifier:GEN_Q025

Would you say that most days at work were...?

  • 1: Not at all stressful
  • 2: Not very stressful
  • 3: A bit stressful
  • 4: Quite a bit stressful
  • 5: Extremely stressful
  • 8: RF
  • 9: DK

General health (GEN) - Question identifier:GEN_Q030

How would you describe your sense of belonging to your local community? Would you say it is...?

  • 1: Very strong
  • 2: Somewhat strong
  • 3: Somewhat weak
  • 4: Very weak
  • 8: RF
  • 9: DK

Height and weight - self reported (HWT)

Height and weight - self reported (HWT) - Question identifier:HWT_Q005

The next questions are about height and weight. How tall are you without shoes on?

  • 0: Less than 1' / 12" (less than 29.2 cm.)
  • 1: 1'0" to 1'11" / 12" to 23" (29.2 to 59.6 cm.)
  • 2: 2'0" to 2'11" / 24" to 35" (59.7 to 90.1 cm.)
  • 3: 3'0" to 3'11" / 36" to 47" (90.2 to 120.6 cm.)
  • 4: 4'0" to 4'11" / 48" to 59" (120.7 to 151.0 cm.)
  • 5: 5'0" to 5'11" (151.1 to 181.5 cm.)
  • 6: 6'0" to 6'11" (181.6 to 212.0 cm.)
  • 7: 7'0" and over (212.1 cm. and over)
  • 8: RF
  • 9: DK

Height and weight - self reported (HWT) - Question identifier:HWT_N010

Select the exact height.

  • 00: Less than or equal to 1'0" / 12" (29.2 to 31.7 cm.)
  • 01: 1'1" / 13" (31.8 to 34.2 cm.)
  • 02: 1'2" / 14" (34.3 to 36.7 cm.)
  • 03: 1'3" / 15" (36.8 to 39.3 cm.)
  • 04: 1'4" / 16" (39.4 to 41.8 cm.)
  • 05: 1'5" / 17" (41.9 to 44.4 cm.)
  • 06: 1'6" / 18" (44.5 to 46.9 cm.)
  • 07: 1'7" / 19" (47.0 to 49.4 cm.)
  • 08: 1'8" / 20" (49.5 to 52.0 cm.)
  • 09: 1'9" / 21" (52.1 to 54.5 cm.)
  • 10: 1'10" / 22" (54.6 to 57.1 cm.)
  • 11: 1'11" / 23" (57.2 to 59.6 cm.)
  • 98: RF
  • 99: DK

Height and weight - self reported (HWT) - Question identifier:HWT_N015

Select the exact height.

  • 00: 2'0" / 24" (59.7 to 62.1 cm.)
  • 01: 2'1" / 25" (62.2 to 64.7 cm.)
  • 02: 2'2" / 26" (64.8 to 67.2 cm.)
  • 03: 2'3" / 27" (67.3 to 69.8 cm.)
  • 04: 2'4" / 28" (69.9 to 72.3 cm.)
  • 05: 2'5" / 29" (72.4 to 74.8 cm.)
  • 06: 2'6" / 30" (74.9 to 77.4 cm.)
  • 07: 2'7" / 31" (77.5 to 79.9 cm.)
  • 08: 2'8" / 32" (80.0 to 82.5 cm.)
  • 09: 2'9" / 33" (82.6 to 85.0 cm.)
  • 10: 2'10" / 34" (85.1 to 87.5 cm.)
  • 11: 2'11" / 35" (87.6 to 90.1 cm.)
  • 98: RF
  • 99: DK

Height and weight - self reported (HWT) - Question identifier:HWT_N020

Select the exact height.

  • 00: 3'0" / 36" (90.2 to 92.6 cm.)
  • 01: 3'1" / 37" (92.7 to 95.2 cm.)
  • 02: 3'2" / 38" (95.3 to 97.7 cm.)
  • 03: 3'3" / 39" (97.8 to 100.2 cm.)
  • 04: 3'4" / 40" (100.3 to 102.8 cm.)
  • 05: 3'5" / 41" (102.9 to 105.3 cm.)
  • 06: 3'6" / 42" (105.4 to 107.9 cm.)
  • 07: 3'7" / 43" (108.0 to 110.4 cm.)
  • 08: 3'8" / 44" (110.5 to 112.9 cm.)
  • 09: 3'9" / 45" (113.0 to 115.5 cm.)
  • 10: 3'10" / 46" (115.6 to 118.0 cm.)
  • 11: 3'11" / 47" (118.1 to 120.6 cm.)
  • 98: RF
  • 99: DK

Height and weight - self reported (HWT) - Question identifier:HWT_N025

Select the exact height.

  • 00: 4'0" / 48" (120.7 to 123.1 cm.)
  • 01: 4'1" / 49" (123.2 to 125.6 cm.)
  • 02: 4'2" / 50" (125.7 to 128.2 cm.)
  • 03: 4'3" / 51" (128.3 to 130.7 cm.)
  • 04: 4'4" / 52" (130.8 to 133.3 cm.)
  • 05: 4'5" / 53" (133.4 to 135.8 cm.)
  • 06: 4'6" / 54" (135.9 to 138.3 cm.)
  • 07: 4'7" / 55" (138.4 to 140.9 cm.)
  • 08: 4'8" / 56" (141.0 to 143.4 cm.)
  • 09: 4'9" / 57" (143.5 to 146.0 cm.)
  • 10: 4'10" / 58" (146.1 to 148.5 cm.)
  • 11: 4'11" / 59" (148.6 to 151.0 cm.)
  • 98: RF
  • 99: DK

Height and weight - self reported (HWT) - Question identifier:HWT_N030

Select the exact height.

  • 00: 5'0" (151.1 to 153.6 cm.)
  • 01: 5'1" (153.7 to 156.1 cm.)
  • 02: 5'2" (156.2 to 158.7 cm.)
  • 03: 5'3" (158.8 to 161.2 cm.)
  • 04: 5'4" (161.3 to 163.7 cm.)
  • 05: 5'5" (163.8 to 166.3 cm.)
  • 06: 5'6" (166.4 to 168.8 cm.)
  • 07: 5'7" (168.9 to 171.4 cm.)
  • 08: 5'8" (171.5 to 173.9 cm.)
  • 09: 5'9" (174.0 to 176.4 cm.)
  • 10: 5'10" (176.5 to 179.0 cm.)
  • 11: 5'11" (179.1 to 181.5 cm.)
  • 98: RF
  • 99: DK

Height and weight - self reported (HWT) - Question identifier:HWT_N035

Select the exact height.

  • 00: 6'0" (181.6 to 184.1 cm.)
  • 01: 6'1" (184.2 to 186.6 cm.)
  • 02: 6'2" (186.7 to 189.1 cm.)
  • 03: 6'3" (189.2 to 191.7 cm.)
  • 04: 6'4" (191.8 to 194.2 cm.)
  • 05: 6'5" (194.3 to 196.8 cm.)
  • 06: 6'6" (196.9 to 199.3 cm.)
  • 07: 6'7" (199.4 to 201.8 cm.)
  • 08: 6'8" (201.9 to 204.4 cm.)
  • 09: 6'9" (204.5 to 206.9 cm.)
  • 10: 6'10" (207.0 to 209.5 cm.)
  • 11: 6'11" (209.6 to 212.0 cm.)
  • 98: RF
  • 99: DK

Height and weight - self reported (HWT) - Question identifier:HWT_Q040

How much do you weigh?

Min = 1; Max = 575

Height and weight - self reported (HWT) - Question identifier:HWT_N045

Was that in pounds or kilograms?

  • 1: Pounds
  • 2: Kilograms

Height and weight - self reported (HWT) - Question identifier:HWT_Q050

Do you consider yourself...?

  • 1: Overweight
  • 2: Underweight
  • 3: Just about right
  • 8: RF
  • 9: DK

Chronic conditions (CCC)

Chronic conditions (CCC) - Question identifier:CCC_R015

The following questions are about "long-term health conditions" which are expected to last or have already lasted 6 months or more and that have been diagnosed by a health professional.

Chronic conditions (CCC) - Question identifier:CCC_Q015

Do you have asthma?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Chronic conditions (CCC) - Question identifier:CCC_Q020

Have you had any asthma symptoms or asthma attacks in the past 12 months?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Chronic conditions (CCC) - Question identifier:CCC_Q025

In the past 12 months, have you taken any medicine for asthma such as inhalers (pumps), nebulizers, pills, liquids or injections?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Chronic conditions (CCC) - Question identifier:CCC_Q030

Do you have chronic bronchitis, emphysema or chronic obstructive pulmonary disease or COPD?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Chronic conditions (CCC) - Question identifier:CCC_Q035

Have you been told by a health professional that you have sleep apnea?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Chronic conditions (CCC) - Question identifier:CCC_R045

Remember, we're interested in conditions diagnosed by a health professional and that are expected to last or have already lasted 6 months or more.

Chronic conditions (CCC) - Question identifier:CCC_Q045

Do you have fibromyalgia?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Chronic conditions (CCC) - Question identifier:CCC_Q050

Do you have arthritis, for example osteoarthritis, rheumatoid arthritis, gout or any other type, excluding fibromyalgia?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Chronic conditions (CCC) - Question identifier:CCC_Q060

Do you have osteoporosis?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Chronic conditions (CCC) - Question identifier:CCC_Q065

Do you have high blood pressure?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Chronic conditions (CCC) - Question identifier:CCC_Q070

In the past month, have you taken any medicine for high blood pressure?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Chronic conditions (CCC) - Question identifier:CCC_Q075

Do you have high blood cholesterol or lipids?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Chronic conditions (CCC) - Question identifier:CCC_Q080

In the past month, have you taken any medicine for high blood cholesterol or lipids?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Chronic conditions (CCC) - Question identifier:CCC_Q085

Do you have heart disease?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Chronic conditions (CCC) - Question identifier:CCC_Q087

Have you ever been diagnosed with heart disease?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Chronic conditions (CCC) - Question identifier:CCC_Q090

Do you suffer from the effects of a stroke?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Chronic conditions (CCC) - Question identifier:CCC_Q095

Do you have diabetes?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Chronic conditions (CCC) - Question identifier:CCC_Q100

How old were you when this was first diagnosed?

Min = 1; Max = 121

Chronic conditions (CCC) - Question identifier:CCC_Q105

Were you pregnant when you were first diagnosed with diabetes?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Chronic conditions (CCC) - Question identifier:CCC_Q110

Other than during pregnancy, has a health professional ever told you that you have diabetes?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Chronic conditions (CCC) - Question identifier:CCC_Q115

When you were first diagnosed with diabetes, how long was it before you were started on insulin?

  • 1: Less than 1 month
  • 2: 1 month to less than 2 months
  • 3: 2 months to less than 6 months
  • 4: 6 months to less than 1 year
  • 5: 1 year or more
  • 6: Never
  • 8: RF
  • 9: DK

Chronic conditions (CCC) - Question identifier:CCC_Q120

Do you currently take insulin for your diabetes?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Chronic conditions (CCC) - Question identifier:CCC_Q125

In the past month, did you take pills to control your blood sugar?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Chronic conditions (CCC) - Question identifier:CCC_Q130

Do you have cancer?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Chronic conditions (CCC) - Question identifier:CCC_Q135

Have you ever been diagnosed with cancer?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Chronic conditions (CCC) - Question identifier:CCC_R140

Remember, we're interested in conditions diagnosed by a health professional and that are expected to last or have already lasted 6 months or more.

Chronic conditions (CCC) - Question identifier:CCC_Q145

Do you have Alzheimer's Disease or any other dementia?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Chronic conditions (CCC) - Question identifier:CCC_Q185

Do you have chronic fatigue syndrome?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Chronic conditions (CCC) - Question identifier:CCC_Q195

Do you have a mood disorder such as depression, bipolar disorder, mania or dysthymia?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Chronic conditions (CCC) - Question identifier:CCC_Q200

Do you have an anxiety disorder such as a phobia, obsessive-compulsive disorder or a panic disorder?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Health utility index (HUI)

Health utility index (HUI) - Question identifier:HUI_R001

The next set of questions asks about your day-to-day health.

You may feel that some of these questions do not apply to you, but it is important that we ask the same questions of everyone.

Health utility index (HUI) - Question identifier:HUI_Q005

Are you usually able to see well enough to read ordinary newsprint without glasses or contact lenses?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Health utility index (HUI) - Question identifier:HUI_Q010

Are you usually able to see well enough to read ordinary newsprint with glasses or contact lenses?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Health utility index (HUI) - Question identifier:HUI_Q015

Are you able to see at all?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Health utility index (HUI) - Question identifier:HUI_Q020

Are you able to see well enough to recognize a friend on the other side of the street without glasses or contact lenses?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Health utility index (HUI) - Question identifier:HUI_Q025

Are you usually able to see well enough to recognize a friend on the other side of the street with glasses or contact lenses?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Health utility index (HUI) - Question identifier:HUI_Q030

Are you usually able to hear what is said in a group conversation with at least three other people without a hearing aid?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Health utility index (HUI) - Question identifier:HUI_Q035

Are you usually able to hear what is said in a group conversation with at least three other people with a hearing aid?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Health utility index (HUI) - Question identifier:HUI_Q040

Are you able to hear at all?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Health utility index (HUI) - Question identifier:HUI_Q045

Are you usually able to hear what is said in a conversation with one other person in a quiet room without a hearing aid?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Health utility index (HUI) - Question identifier:HUI_Q050

Are you usually able to hear what is said in a conversation with one other person in a quiet room with a hearing aid?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Health utility index (HUI) - Question identifier:HUI_Q055

Are you usually able to be understood completely when speaking with strangers in your own language?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Health utility index (HUI) - Question identifier:HUI_Q060

Are you able to be understood partially when speaking with strangers?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Health utility index (HUI) - Question identifier:HUI_Q065

Are you able to be understood completely when speaking with those who know you well?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Health utility index (HUI) - Question identifier:HUI_Q070

Are you able to be understood partially when speaking with those who know you well?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Health utility index (HUI) - Question identifier:HUI_Q075

Are you usually able to walk around the neighbourhood without difficulty and without mechanical support such as braces, a cane or crutches?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Health utility index (HUI) - Question identifier:HUI_Q080

Are you able to walk at all?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Health utility index (HUI) - Question identifier:HUI_Q085

Do you require mechanical support such as braces, a cane or crutches to be able to walk around the neighbourhood?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Health utility index (HUI) - Question identifier:HUI_Q090

Do you require the help of another person to be able to walk?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Health utility index (HUI) - Question identifier:HUI_Q095

Do you require a wheelchair to get around?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Health utility index (HUI) - Question identifier:HUI_Q100

How often do you use a wheelchair?

  • 1: Always
  • 2: Often
  • 3: Sometimes
  • 4: Never
  • 8: RF
  • 9: DK

Health utility index (HUI) - Question identifier:HUI_Q105

Do you need the help of another person to get around in the wheelchair?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Health utility index (HUI) - Question identifier:HUI_Q110

Are you usually able to grasp and handle small objects such as a pencil or scissors?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Health utility index (HUI) - Question identifier:HUI_Q115

Do you require the help of another person because of limitations in the use of your hands or fingers?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Health utility index (HUI) - Question identifier:HUI_Q120

Do you require the help of another person with...?

  • 1: Some tasks
  • 2: Most tasks
  • 3: Almost all tasks
  • 4: All tasks
  • 8: RF
  • 9: DK

Health utility index (HUI) - Question identifier:HUI_Q125

Do you require special equipment, for example, devices to assist in dressing, because of limitations in the use of your hands or fingers?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Health utility index (HUI) - Question identifier:HUI_Q130

Would you describe yourself as being usually...?

  • 1: Happy and interested in life
  • 2: Somewhat happy
  • 3: Somewhat unhappy
  • 4: Unhappy with little interest in life
  • 5: So unhappy, that life is not worthwhile
  • 8: RF
  • 9: DK

Health utility index (HUI) - Question identifier:HUI_Q135

How would you describe your usual ability to remember things?

  • 1: Able to remember most things
  • 2: Somewhat forgetful
  • 3: Very forgetful
  • 4: Unable to remember anything at all
  • 8: RF
  • 9: DK

Health utility index (HUI) - Question identifier:HUI_Q140

How would you describe your usual ability to think and solve day-to-day problems?

  • 1: Able to think clearly and solve problems
  • 2: Having a little difficulty
  • 3: Having some difficulty
  • 4: Having a great deal of difficulty
  • 5: Unable to think or solve problems
  • 8: RF
  • 9: DK

Health utility index (HUI) - Question identifier:HUI_R145

The next set of questions asks about the level of pain or discomfort you usually experience. They are not about illnesses like colds that affect people for short periods of time.

Health utility index (HUI) - Question identifier:HUI_Q145

Are you usually free of pain or discomfort?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Health utility index (HUI) - Question identifier:HUI_Q150

How would you describe the usual intensity of your pain or discomfort?

  • 1: Mild
  • 2: Moderate
  • 3: Severe
  • 8: RF
  • 9: DK

Health utility index (HUI) - Question identifier:HUI_Q155

How many activities does your pain or discomfort prevent?

  • 1: None
  • 2: A few
  • 3: Some
  • 4: Most
  • 8: RF
  • 9: DK

Injuries (INJ)

Injuries (INJ) - Question identifier:INJ_R001

Now, questions on repetitive strain injuries. By this we mean injuries to muscles, tendons or nerves caused by overuse or repeating the same movement over an extended period. For example, carpal tunnel syndrome, tennis elbow or tendonitis.

Injuries (INJ) - Question identifier:INJ_Q005

In the past 12 months, did you have any injuries due to repetitive strain?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Injuries (INJ) - Question identifier:INJ_Q010

Were these injuries serious enough to limit your normal activities?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Injuries (INJ) - Question identifier:INJ_Q015

Thinking about the most serious repetitive strain injury, what part of the body was affected?

  • 01: Head
  • 02: Neck
  • 03: Shoulder, upper arm
  • 04: Elbow, lower arm
  • 05: Wrist
  • 06: Hand
  • 07: Hip
  • 08: Thigh
  • 09: Knee, lower leg
  • 10: Ankle, foot
  • 11: Upper back or upper spine (excluding neck)
  • 12: Lower back or lower spine
  • 13: Chest (excluding back and spine)
  • 14: Abdomen or pelvis (excluding back and spine)
  • 98: RF
  • 99: DK

Injuries (INJ) - Question identifier:INJ_Q020

What type of activity caused this repetitive strain injury?

  • 01: Walking
  • 02: Sports or physical exercise (including school activities and running)
  • 03: Leisure or hobby (include volunteering)
  • 04: Household chores, outdoor yard maintenance, home renovations or other unpaid work
  • 05: Computer use or typing
  • 06: Driving a motor vehicle
  • 07: Lifting or carrying an object or person
  • 08: Other
  • 98: RF
  • 99: DK

Injuries (INJ) - Question identifier:INJ_Q025

Was the activity something you did while working at your job or business (excluding travel to or from work)?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Injuries (INJ) - Question identifier:INJ_R030

For the next questions, think about other injuries which occurred in the past 12 months, and were serious enough to limit your normal activities at least 24 hours after the injury occurred. For example, a broken bone, a bad cut, a burn or a sprain.

Injuries (INJ) - Question identifier:INJ_Q030

Not counting [repetitive strain injuries or] food poisoning, in the past 12 months, that is, from [Date one year ago] to yesterday, were you injured?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Injuries (INJ) - Question identifier:INJ_Q035

How many times were you injured?

Min = 1; Max = 30

Injuries (INJ) - Question identifier:INJ_Q040

[Thinking about the most serious injury,] in which month did it happen?

  • 01: January
  • 02: February
  • 03: March
  • 04: April
  • 05: May
  • 06: June
  • 07: July
  • 08: August
  • 09: September
  • 10: October
  • 11: November
  • 12: December
  • 98: RF
  • 99: DK

Injuries (INJ) - Question identifier:INJ_Q045

Was that this year or last year?

  • 1: This year
  • 2: Last year
  • 8: RF
  • 9: DK

Injuries (INJ) - Question identifier:INJ_Q050

What type of injury did you have? For example, a broken bone or burn.

  • 01: Multiple serious injuries (excluding multiple minor injuries)
  • 02: Broken or fractured bones
  • 03: Burn, scald, chemical burn
  • 04: Dislocation
  • 05: Sprain or strain (including torn ligaments and muscles)
  • 06: Cut, puncture, animal or human bite (open wound)
  • 07: Scrape(s), bruise(s), blister(s) (including multiple minor injuries)
  • 08: Concussion or other brain injury
  • 09: Poisoning (excluding food poisoning, poison ivy, other contact dermatitis, and allergies)
  • 10: Injury to internal organs
  • 11: Other - Specify
  • 98: RF
  • 99: DK

Injuries (INJ) - Question identifier:INJ_Q055

What part of the body was injured?

  • 01: Multiple sites
  • 02: Eyes (excluding fracture of facial bones around the eye)
  • 03: Head (including facial bones)
  • 04: Neck
  • 05: Shoulder, upper arm
  • 06: Elbow, lower arm
  • 07: Wrist
  • 08: Hand
  • 09: Hip
  • 10: Thigh
  • 11: Knee, lower leg
  • 12: Ankle, foot
  • 13: Upper back or upper spine (excluding neck)
  • 14: Lower back or lower spine
  • 15: Chest (excluding back and spine)
  • 16: Abdomen or pelvis (excluding back and spine)
  • 17: Other
  • 98: RF
  • 99: DK

Injuries (INJ) - Question identifier:INJ_Q060

Where were you when you were injured? For example, someone's house, an office building, construction site.

  • 01: In a home or its surrounding area (including respondent's home or other homes)
  • 02: Residential institution (e.g., nursing home, long term care)
  • 03: School, college, university (exclude sports areas)
  • 04: Sports or athletics area of school, college, university
  • 05: Other sports or athletics area (exclude school sports areas)
  • 06: Other institution (e.g., church, hospital, theatre, civic building)
  • 07: Street, highway, sidewalk
  • 08: Commercial area (e.g., store, restaurant, office building, transport terminal)
  • 09: Industrial or construction area
  • 10: Farm (exclude farmhouse and its surrounding area)
  • 11: Countryside, forest, lake, ocean, mountains, prairie, etc.
  • 12: Other
  • 98: RF
  • 99: DK

Injuries (INJ) - Question identifier:INJ_Q065

What were you doing when you were injured?

  • 01: Organized sports involving coaching and competitions
  • 02: Leisure sports or physical exercise, including school activities and running
  • 03: Non-sport leisure or hobby (including volunteering)
  • 04: Working at a job or business (excluding travel to and from work)
  • 05: Household chores, outdoor yard maintenance, home renovations or other unpaid work
  • 06: Sleeping, eating, personal care
  • 07: Going up and down stairs
  • 08: Driver or passenger in/on road motor vehicle (including motorcycles and trucks)
  • 09: Driver or passenger in/on off-road motor vehicle (including boat, ATV, snowmobile)
  • 10: Walking
  • 11: Other - Specify
  • 98: RF
  • 99: DK

Injuries (INJ) - Question identifier:INJ_Q070

Was the injury the result of a fall?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Injuries (INJ) - Question identifier:INJ_Q075

How did you fall?

  • 01: While skating, skiing or snowboarding
  • 02: While engaged in other sport or physical exercise (including school activities and running)
  • 03: Going up or down stairs / steps (icy or not)
  • 04: Slip, trip or stumble, or loss of balance while walking on ice or snow
  • 05: Slip, trip or stumble, or loss of balance while walking on any other surface
  • 06: From furniture or while rising from furniture (e.g., bed, chair)
  • 07: From elevated position (e.g., ladder, tree, scaffolding)
  • 08: Due to health problems (e.g., faint, weakness, dizziness, hip/knee gave out, seizure)
  • 09: Other - Specify
  • 98: RF
  • 99: DK

Injuries (INJ) - Question identifier:INJ_Q080

What caused the injury? For example, wrong movement, accidental contact with an object, transportation accident.

  • 01: Transportation accident
  • 02: Accidentally bumped, pushed, bitten, etc. by a person or animal
  • 03: Accidentally struck or crushed by object(s)
  • 04: Accidental contact with sharp object, tool or machine
  • 05: Smoke, fire, flames
  • 06: Accidental contact with hot object, liquid or gas
  • 07: Extreme weather or natural disaster
  • 08: Overexertion or strenuous movement
  • 09: Physical assault
  • 10: Intentional self-inflicted injury
  • 11: Other - Specify
  • 98: RF
  • 99: DK

Injuries (INJ) - Question identifier:INJ_Q085

At what time of day did your injury occur?

  • 1: Morning (06:00-11:59)
  • 2: Afternoon (12:00-17:59)
  • 3: Evening (18:00-23:59)
  • 4: Night (00:00-05:59)
  • 8: RF
  • 9: DK

Injuries (INJ) - Question identifier:INJ_Q090

Did you receive any medical attention for the injury from a health professional in the 48 hours following the injury?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Injuries (INJ) - Question identifier:INJ_Q095

Where did you initially go to receive treatment within the first 48 hours following the injury?

  • 01: Doctor's office
  • 02: Hospital emergency room
  • 03: Hospital outpatient clinic (e.g., day surgery)
  • 04: Other clinic (e.g., walk-in, appointment, sports)
  • 05: Physiotherapist or massage therapist's office
  • 06: Community health centre / CLSC
  • 07: Chiropractor's office
  • 08: Where the injury happened/on-site (workplace, school, sports field, hotel, ski hill)
  • 09: Other
  • 98: RF
  • 99: DK

Injuries (INJ) - Question identifier:INJ_Q100

Were you admitted to a hospital overnight because of this injury?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Injuries (INJ) - Question identifier:INJ_Q105

At the present time, are you getting follow-up care from a health professional because of this injury?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Injuries (INJ) - Question identifier:INJ_Q110

In the past 12 months, [excluding injuries previously mentioned,] did have any other injuries that were treated by a health professional, but did not limit your normal activities?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Injuries (INJ) - Question identifier:INJ_Q115

How many injuries?

Min = 1; Max = 30

Oral health (OHT)

Oral health (OHT) - Question identifier:OHT_R001

Now, some questions about the health of your mouth, including your teeth or dentures, tongue, gums, lips and jaw joints.

Oral health (OHT) - Question identifier:OHT_Q005

In general, would you say the health of your mouth is...?

  • 1: Excellent
  • 2: Very good
  • 3: Good
  • 4: Fair
  • 5: Poor
  • 8: RF
  • 9: DK

Oral health (OHT) - Question identifier:OHT_Q010

How satisfied are you with the appearance of your teeth and/or dentures?

  • 1: Very satisfied
  • 2: Satisfied
  • 3: Neither satisfied nor dissatisfied
  • 4: Dissatisfied
  • 5: Very dissatisfied
  • 8: RF
  • 9: DK

Oral health (OHT) - Question identifier:OHT_Q015

In the past 12 months, how often have you found it uncomfortable to eat any food because of problems with your mouth?

  • 1: Often
  • 2: Sometimes
  • 3: Rarely
  • 4: Never
  • 8: RF
  • 9: DK

Oral health (OHT) - Question identifier:OHT_Q020

(In the past 12 months,) how often have you avoided eating particular foods because of problems with your mouth?

  • 1: Often
  • 2: Sometimes
  • 3: Rarely
  • 4: Never
  • 8: RF
  • 9: DK

Oral health (OHT) - Question identifier:OHT_Q025

Remember, by mouth we mean teeth, dentures, tongue, gums, lips and jaw joints.

In the past 12 months, how often have you had any other persistent or on-going pain anywhere in your mouth?

  • 1: Often
  • 2: Sometimes
  • 3: Rarely
  • 4: Never
  • 8: RF
  • 9: DK

Oral health (OHT) - Question identifier:OHT_Q030

Do you have at least one of your own teeth?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Oral health (OHT) - Question identifier:OHT_Q035

Do you wear dentures, dental prosthesis or false teeth?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Oral health (OHT) - Question identifier:OHT_Q040

In the past 12 months, how often have you had bleeding gums, including while brushing or flossing your teeth?

  • 1: Often
  • 2: Sometimes
  • 3: Rarely
  • 4: Never
  • 8: RF
  • 9: DK

Oral health (OHT) - Question identifier:OHT_Q045

(In the past 12 months,) how often have you had persistent dry mouth?

  • 1: Often
  • 2: Sometimes
  • 3: Rarely
  • 4: Never
  • 8: RF
  • 9: DK

Oral health (OHT) - Question identifier:OHT_Q050

(In the past 12 months,) how often have you had persistent bad breath?

  • 1: Often
  • 2: Sometimes
  • 3: Rarely
  • 4: Never
  • 8: RF
  • 9: DK

Changes made to improve health (CIH)

Changes made to improve health (CIH) - Question identifier:CIH_Q005

Now, some questions about changes made to improve health.

In the past 12 months, did you do anything to improve your health? (For example, lost weight, quit smoking, increased exercise.)

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Changes made to improve health (CIH) - Question identifier:CIH_Q010

What is the single most important change you have made?

  • 01: Increased exercise, sports / physical activity
  • 02: Lost weight
  • 03: Changed diet / improved eating habits
  • 04: Quit smoking / reduced amount smoked
  • 05: Drank less alcohol
  • 06: Reduced stress level
  • 07: Received medical treatment
  • 08: Took vitamins
  • 09: Other
  • 98: RF
  • 99: DK

Changes made to improve health (CIH) - Question identifier:CIH_Q015

Do you think there is [anything / anything else] you should do to improve your physical health?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Changes made to improve health (CIH) - Question identifier:CIH_Q020

What is the most important thing?

  • 01: Start / Increase exercise, sports / physical activity
  • 02: Lose weight
  • 03: Change diet / improve eating habits
  • 04: Quit smoking / reduce amount smoked
  • 05: Drink less alcohol
  • 06: Reduce stress level
  • 07: Receive medical treatment
  • 08: Take vitamins
  • 09: Other
  • 98: RF
  • 99: DK

Changes made to improve health (CIH) - Question identifier:CIH_Q025

Is there anything stopping you from making this improvement?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Changes made to improve health (CIH) - Question identifier:CIH_Q030

What is that?

  • 01: Lack of will power / self-discipline
  • 02: Family responsibilities
  • 03: Work schedule
  • 04: Addiction to drugs / alcohol
  • 05: Disability / health condition
  • 06: Too stressed
  • 07: Too costly / financial constraints
  • 08: Not available in area
  • 09: Transportation problems
  • 10: Weather problems
  • 11: Other
  • 98: RF
  • 99: DK

Changes made to improve health (CIH) - Question identifier:CIH_Q035

Is there anything you intend to do to improve your physical health in the next year?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Changes made to improve health (CIH) - Question identifier:CIH_Q040

What is that?

  • 01: Start / Increase exercise, sports / physical activity
  • 02: Lose weight
  • 03: Change diet / improve eating habits
  • 04: Quit smoking / reduce amount smoked
  • 05: Drink less alcohol
  • 06: Reduce stress level
  • 07: Receive medical treatment
  • 08: Take vitamins
  • 09: Other
  • 98: RF
  • 99: DK

Fruit and vegetable consumption (FVC)

Fruit and vegetable consumption (FVC) - Question identifier:FVC_R001

These next questions are about the fruits and vegetables you ate or drank during the last month. Think about all meals and snacks, at home and away from home.

Fruit and vegetable consumption (FVC) - Question identifier:FVC_Q004

In the last month, did you drink 100% PURE fruit juices, such as pure orange juice, apple juice or pure juice blends? Exclude fruit-flavored drinks with added sugar or fruit punch.

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Fruit and vegetable consumption (FVC) - Question identifier:FVC_Q005

How many times? You can report per day, per week or per month.

Min = 1; Max = 300

Fruit and vegetable consumption (FVC) - Question identifier:FVC_N005A

Select the reporting period that corresponds to FVC_Q005.

  • 1: Per day
  • 2: Per week
  • 3: Per month

Fruit and vegetable consumption (FVC) - Question identifier:FVC_Q009

In the last month, not counting juice, did you eat fruit? Please remember to include frozen, dried or canned fruit.

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Fruit and vegetable consumption (FVC) - Question identifier:FVC_Q010

How many times? (You can report per day, per week or per month.)

Min = 1; Max = 300

Fruit and vegetable consumption (FVC) - Question identifier:FVC_N010A

Select the reporting period that corresponds to FVC_Q010.

  • 1: Per day
  • 2: Per week
  • 3: Per month

Fruit and vegetable consumption (FVC) - Question identifier:FVC_Q014

In the last month, did you eat dark green vegetables such as broccoli, green beans, peas and green peppers or dark leafy greens including romaine or spinach? Please remember to include (frozen or canned vegetables and) vegetables that were cooked in soups or mixed in salad.

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Fruit and vegetable consumption (FVC) - Question identifier:FVC_Q015

How many times? (You can report per day, per week or per month.)

Min = 1; Max = 300

Fruit and vegetable consumption (FVC) - Question identifier:FVC_N015A

Select the reporting period that corresponds to FVC_Q015.

  • 1: Per day
  • 2: Per week
  • 3: Per month

Fruit and vegetable consumption (FVC) - Question identifier:FVC_Q019

In the last month, did you eat orange-coloured vegetables such as carrots, orange bell pepper, sweet potatoes, pumpkin or squash? (Please remember to include frozen or canned vegetables and vegetables that were cooked in soups or mixed in salad).

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Fruit and vegetable consumption (FVC) - Question identifier:FVC_Q020

How many times? (You can report per day, per week or per month.)

Min = 1; Max = 300

Fruit and vegetable consumption (FVC) - Question identifier:FVC_N020A

Select the reporting period that corresponds to FVC_Q020.

  • 1: Per day
  • 2: Per week
  • 3: Per month

Fruit and vegetable consumption (FVC) - Question identifier:FVC_Q024

In the last month, did you eat potatoes that are not deep fried?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Fruit and vegetable consumption (FVC) - Question identifier:FVC_Q025

How many times? (You can report per day, per week or per month.)

Min = 1; Max = 300

Fruit and vegetable consumption (FVC) - Question identifier:FVC_N025A

Select the reporting period that corresponds to FVC_Q025.

  • 1: Per day
  • 2: Per week
  • 3: Per month

Fruit and vegetable consumption (FVC) - Question identifier:FVC_Q029

[Excluding the green and orange vegetables as well as the potatoes you have already reported,] in the last month, did you eat OTHER vegetables? Examples include cucumber, celery, corn, cabbage and vegetable juice.

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Fruit and vegetable consumption (FVC) - Question identifier:FVC_Q030

How many times? (You can report per day, per week or per month.)

Min = 1; Max = 300

Fruit and vegetable consumption (FVC) - Question identifier:FVC_N030A

Select the reporting period that corresponds to FVC_Q030.

  • 1: Per day
  • 2: Per week
  • 3: Per month

Canada's Food Guide use (FGU)

Canada's Food Guide use (FGU) - Question identifier:FGU_Q005

Have you ever seen or heard of Canada's Food Guide?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Canada's Food Guide use (FGU) - Question identifier:FGU_Q010

Have you ever used information from Canada's Food Guide?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Canada's Food Guide use (FGU) - Question identifier:FGU_Q015

What did you use the information for?

  • 1: To choose foods for you or household members
  • 2: To determine how much you or household members need to eat every day
  • 3: To plan meals or to help with grocery shopping
  • 4: To assess how well you or household members are eating
  • 5: Other
  • 6: None of the above
  • 8: RF
  • 9: DK

Smoking (SMK)

Smoking (SMK) - Question identifier:SMK_R001

The next questions are about cigarette smoking.

Smoking (SMK) - Question identifier:SMK_Q005

At the present time, do you smoke cigarettes every day, occasionally or not at all?

  • 1: Daily
  • 2: Occasionally
  • 3: Not at all
  • 8: RF
  • 9: DK

Smoking (SMK) - Question identifier:SMK_Q010

In the past 30 days, did you smoke any cigarettes?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Smoking (SMK) - Question identifier:SMK_Q015

During the past 30 days, did you smoke every day?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Smoking (SMK) - Question identifier:SMK_Q020

Have you smoked more than 100 cigarettes (about 4 packs) in your life?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Smoking (SMK) - Question identifier:SMK_Q025

Have you ever smoked a whole cigarette?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Smoking (SMK) - Question identifier:SMK_Q030

Have you ever smoked cigarettes daily?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Smoking (SMK) - Question identifier:SMK_Q035

At what age did you smoke your first whole cigarette?

Min = 5; Max = 121

Smoking (SMK) - Question identifier:SMK_Q040

At what age did you begin to smoke cigarettes daily?

Min = 5; Max = 121

Smoking (SMK) - Question identifier:SMK_Q045

How many cigarettes do you smoke each day now?

Min = 1; Max = 99

Smoking (SMK) - Question identifier:SMK_Q050

On the days that you do smoke, how many cigarettes do you usually smoke?

Min = 1; Max = 99

Smoking (SMK) - Question identifier:SMK_Q055

In the past month, on how many days have you smoked one or more cigarettes?

Min = 0; Max = 31

Smoking (SMK) - Question identifier:SMK_Q060

When did you stop smoking? Was it...?

  • 1: Less than one year ago
  • 2: 1 year to less than 2 years ago
  • 3: 2 years to less than 3 years ago
  • 4: 3 or more years ago
  • 8: RF
  • 9: DK

Smoking (SMK) - Question identifier:SMK_Q065

In what month did you stop?

  • 01: January
  • 02: February
  • 03: March
  • 04: April
  • 05: May
  • 06: June
  • 07: July
  • 08: August
  • 09: September
  • 10: October
  • 11: November
  • 12: December
  • 98: RF
  • 99: DK

Smoking (SMK) - Question identifier:SMK_Q070

How many years ago was it?

Min = 3; Max = 121

Smoking (SMK) - Question identifier:SMK_Q075

When you smoked every day, how many cigarettes did you usually smoke each day?

Min = 1; Max = 99

Smoking (SMK) - Question identifier:SMK_Q080

When did you stop smoking daily? Was it...?

  • 1: Less than one year ago
  • 2: 1 year to less than 2 years ago
  • 3: 2 years to less than 3 years ago
  • 4: 3 or more years ago
  • 8: RF
  • 9: DK

Smoking (SMK) - Question identifier:SMK_Q085

In what month did you stop?

  • 01: January
  • 02: February
  • 03: March
  • 04: April
  • 05: May
  • 06: June
  • 07: July
  • 08: August
  • 09: September
  • 10: October
  • 11: November
  • 12: December
  • 98: RF
  • 99: DK

Smoking (SMK) - Question identifier:SMK_Q090

How many years ago was it?

Min = 3; Max = 121

Smoking (SMK) - Question identifier:SMK_Q095

Was that when you completely quit smoking?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Smoking (SMK) - Question identifier:SMK_Q100

When did you stop smoking completely? Was it...?

  • 1: Less than one year ago
  • 2: 1 year to less than 2 years ago
  • 3: 2 years to less than 3 years ago
  • 4: 3 or more years ago
  • 8: RF
  • 9: DK

Smoking (SMK) - Question identifier:SMK_Q105

In what month did you stop?

  • 01: January
  • 02: February
  • 03: March
  • 04: April
  • 05: May
  • 06: June
  • 07: July
  • 08: August
  • 09: September
  • 10: October
  • 11: November
  • 12: December
  • 98: RF
  • 99: DK

Smoking (SMK) - Question identifier:SMK_Q110

How many years ago was it?

Min = 3; Max = 121

Smoking cessation methods (SCA)

Smoking cessation methods (SCA) - Question identifier:SCA_Q005

In the past 12 months, did you try a nicotine patch to reduce or quit smoking?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Smoking cessation methods (SCA) - Question identifier:SCA_Q010

How useful was that in helping you reduce or quit smoking?

  • 1: Very useful
  • 2: Somewhat useful
  • 3: Not very useful
  • 4: Not useful at all
  • 8: RF
  • 9: DK

Smoking cessation methods (SCA) - Question identifier:SCA_Q015

In the past 12 months, did you use nicotine gum such as 'Nicorette' to reduce or quit smoking?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Smoking cessation methods (SCA) - Question identifier:SCA_Q020

How useful was that in helping you reduce or quit smoking?

  • 1: Very useful
  • 2: Somewhat useful
  • 3: Not very useful
  • 4: Not useful at all
  • 8: RF
  • 9: DK

Smoking cessation methods (SCA) - Question identifier:SCA_Q025

In the past 12 months, did you try medication such as Zyban, Wellbutrin or Champix to reduce or quit smoking?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Smoking cessation methods (SCA) - Question identifier:SCA_Q030

How useful was that in helping you reduce or quit smoking?

  • 1: Very useful
  • 2: Somewhat useful
  • 3: Not very useful
  • 4: Not useful at all
  • 8: RF
  • 9: DK

Smoking cessation methods (SCA) - Question identifier:SCA_Q035

In the past 12 months, did you stop smoking for at least 24 hours because you were trying to reduce or quit?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Smoking cessation methods (SCA) - Question identifier:SCA_Q040

In the past 12 months, did you try any of the following to reduce or quit smoking:

a nicotine patch?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Smoking cessation methods (SCA) - Question identifier:SCA_Q045

(In the past 12 months, did you try any of the following to reduce or quit smoking:)

nicotine gum such as Nicorette?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Smoking cessation methods (SCA) - Question identifier:SCA_Q050

(In the past 12 months, did you try any of the following to reduce or quit smoking:)

medication such as Zyban, Wellbutrin or Champix?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Tobacco products alternatives (TAL)

Tobacco products alternatives (TAL) - Question identifier:TAL_R001

Now, I would like to ask you a few questions about tobacco products, other than cigarettes.

Tobacco products alternatives (TAL) - Question identifier:TAL_Q005

In the past 30 days, did you smoke any little cigars or cigarillos?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Tobacco products alternatives (TAL) - Question identifier:TAL_Q010

Were these (little cigars or cigarillos) plain, flavoured or both?

  • 1: Plain
  • 2: Flavoured
  • 3: Both
  • 8: RF
  • 9: DK

Tobacco products alternatives (TAL) - Question identifier:TAL_Q015

In the past 30 days, did you smoke any cigars other than little cigars or cigarillos?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Tobacco products alternatives (TAL) - Question identifier:TAL_Q020

In the past 30 days, did you use an electronic cigarette, also known as an 'e-cigarette'?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Tobacco products alternatives (TAL) - Question identifier:TAL_Q025

(In the past 30 days,) did you smoke a pipe?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Tobacco products alternatives (TAL) - Question identifier:TAL_Q030

(In the past 30 days,) did you use any chewing tobacco, pinch or snuff?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Tobacco products alternatives (TAL) - Question identifier:TAL_Q035

In the past 30 days, did you smoke a tobacco water-pipe, also known as a hookah, shisha, nargeelay, hubble-bubble or gouza to smoke tobacco?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Nicotine dependence (NDE)

Nicotine dependence (NDE) - Question identifier:NDE_Q005

How soon after you wake up do you smoke your first cigarette?

  • 1: Within 5 minutes
  • 2: 6 - 30 minutes after waking
  • 3: 31 - 60 minutes after waking
  • 4: More than 60 minutes after waking
  • 8: RF
  • 9: DK

Nicotine dependence (NDE) - Question identifier:NDE_Q010

Do you find it difficult to refrain from smoking in places where it is forbidden?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Nicotine dependence (NDE) - Question identifier:NDE_Q015

Which cigarette would you most hate to give up?

  • 1: The first one of the day
  • 2: Another one
  • 8: RF
  • 9: DK

Nicotine dependence (NDE) - Question identifier:NDE_Q020

Do you smoke more frequently during the first hours after waking, compared with the rest of the day?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Nicotine dependence (NDE) - Question identifier:NDE_Q025

Do you smoke even if you are so ill that you are in bed most of the day?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Youth access to cigarettes (YAC)

Youth access to cigarettes (YAC) - Question identifier:YAC_Q005

Where do you usually get your cigarettes?

(Do you buy them, or does someone usually give them to you? Where do you buy them? Who do you get them from?)

  • 01: Buy from - Vending machine
  • 02: Buy from - Small grocery / corner store
  • 03: Buy from - Supermarket
  • 04: Buy from - Drug store
  • 05: Buy from - Gas station
  • 06: Buy from - Other store
  • 07: Buy from or through - Friend or someone else
  • 08: Given them by - Brother or sister
  • 09: Given them by - Mother or father
  • 10: Given them by - Friend or someone else
  • 11: Take them from - Mother, father or sibling
  • 12: Buy from - a First Nations Reserve (i.e. delivery service)
  • 13: Buy on - a First Nations Reserve
  • 14: Other
  • 98: RF
  • 99: DK

Youth access to cigarettes (YAC) - Question identifier:YAC_Q010

In the past 12 months, have you bought or tried to buy cigarettes from a store?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Youth access to cigarettes (YAC) - Question identifier:YAC_Q015

In the past 12 months, have you been asked for ID when buying cigarettes in a store?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Youth access to cigarettes (YAC) - Question identifier:YAC_Q020

(In the past 12 months), has anyone in a store refused to sell you cigarettes?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Youth access to cigarettes (YAC) - Question identifier:YAC_Q025

(In the past 12 months), have you asked anyone to buy cigarettes for you?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Exposure to second hand smoke (ETS)

Exposure to second hand smoke (ETS) - Question identifier:ETS_R001

The next questions are about exposure to second-hand smoke.

Exposure to second hand smoke (ETS) - Question identifier:ETS_Q005

Including both household members and regular visitors, does anyone smoke inside your home, every day or almost every day?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Exposure to second hand smoke (ETS) - Question identifier:ETS_Q010

How many people smoke inside your home every day or almost every day?

Min = 1; Max = 15

Exposure to second hand smoke (ETS) - Question identifier:ETS_Q015

Is smoking allowed inside your home?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Exposure to second hand smoke (ETS) - Question identifier:ETS_Q020

Is smoking inside your home restricted in any way?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Exposure to second hand smoke (ETS) - Question identifier:ETS_Q025

How is smoking restricted inside your home?

  • 1: Allowed in certain rooms only
  • 2: Restricted in the presence of young children
  • 3: Allowed only if windows are open or with another type of ventilation
  • 4: Other restriction(s)
  • 8: RF
  • 9: DK

Exposure to second hand smoke (ETS) - Question identifier:ETS_Q030

In the past month, were you exposed to second-hand smoke, every day or almost every day, at your workplace or at school?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Exposure to second hand smoke (ETS) - Question identifier:ETS_Q035

In the past month, were you exposed to second-hand smoke, every day or almost every day, in a car or other private vehicle?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Exposure to second hand smoke (ETS) - Question identifier:ETS_Q040

In the past month, were you exposed to second-hand smoke, every day or almost every day, in public places (such as bars, restaurants, shopping malls, arenas, bingo halls, bowling alleys)?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Alcohol use (ALC)

Alcohol use (ALC) - Question identifier:ALC_R001

Now, some questions about your alcohol consumption.
A 'drink' refers to:
- a bottle or small can of beer, cider or cooler with 5% alcohol content, or a small draft;
- a glass of wine with 12% alcohol content;
- a glass or cocktail containing 1¿ oz. of a spirit with 40% alcohol content.

Alcohol use (ALC) - Question identifier:ALC_Q005

Have you ever had a drink in your lifetime?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Alcohol use (ALC) - Question identifier:ALC_Q010

During the past 12 months, that is, from [Date one year ago] to yesterday, have you had a drink of beer, wine, liquor or any other alcoholic beverage?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Alcohol use (ALC) - Question identifier:ALC_Q015

During the past 12 months, how often did you drink alcoholic beverages?

  • 1: Less than once a month
  • 2: Once a month
  • 3: 2 to 3 times a month
  • 4: Once a week
  • 5: 2 to 3 times a week
  • 6: 4 to 6 times a week
  • 7: Every day
  • 8: RF
  • 9: DK

Alcohol use (ALC) - Question identifier:ALC_Q020

How often in the past 12 months have you had [4 / 5] or more drinks on one occasion?

  • 1: Never
  • 2: Less than once a month
  • 3: Once a month
  • 4: 2 to 3 times a month
  • 5: Once a week
  • 6: More than once a week
  • 8: RF
  • 9: DK

Alcohol use during the past week (ALW)

Alcohol use during the past week (ALW) - Question identifier:ALW_Q005

Thinking back over the past week, that is, from last [Day of the week 7 days ago] to yesterday, did you have a drink of beer, wine, liquor or any other alcoholic beverage?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Alcohol use during the past week (ALW) - Question identifier:ALW_Q010

Starting with yesterday, that is [Day 1], how many drinks did you have?

Min = 0; Max = 99

Alcohol use during the past week (ALW) - Question identifier:ALW_Q015

How many drinks did you have:

on [Day 2]?

Min = 0; Max = 99

Alcohol use during the past week (ALW) - Question identifier:ALW_Q020

How many drinks did you have:

on [Day 3]?

Min = 0; Max = 99

Alcohol use during the past week (ALW) - Question identifier:ALW_Q025

How many drinks did you have:

on [Day 4]?

Min = 0; Max = 99

Alcohol use during the past week (ALW) - Question identifier:ALW_Q030

How many drinks did you have:

on [Day 5]?

Min = 0; Max = 99

Alcohol use during the past week (ALW) - Question identifier:ALW_Q035

How many drinks did you have:

on [Day 6]?

Min = 0; Max = 99

Alcohol use during the past week (ALW) - Question identifier:ALW_Q040

How many drinks did you have:

on [Day 7]?

Min = 0; Max = 99

Antibiotic medication use (AMU)

Antibiotic medication use (AMU) - Question identifier:AMU_R005

The next questions are about oral antibiotics that have been prescribed to you in the past 12 months, including those received at a hospital for later use. Please exclude the antibiotics administered to you while in the hospital.

Antibiotic medication use (AMU) - Question identifier:AMU_Q005

In the past 12 months, have you been prescribed any oral antibiotics?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Antibiotic medication use (AMU) - Question identifier:AMU_Q010

In the past 12 months, were you prescribed more than one (oral antibiotic)?

  • 1: Yes
  • 2: No, just one
  • 8: RF
  • 9: DK

Antibiotic medication use (AMU) - Question identifier:AMU_Q015

[Thinking of the last time you were prescribed an oral antibiotic (in the past 12 months)], what medical reason was your prescription for?

  • 1: Chest infection (e.g., bronchitis, bronchiolitis, pneumonia, chest cough)
  • 2: Ear, nose, throat, sinus, eye infection (e.g., strep throat, pink eye, sinusitis, sore throat, pharyngitis, tonsillitis)
  • 3: Urinary tract infection - UTI (e.g., bladder, kidney, urethra infection)
  • 4: Skin infection (e.g., acne, cellulitis, abscess, boil, nail infection)
  • 5: Gastrointestinal infection (e.g., food poisoning, diarrhea, vomiting, gastritis, ulcer)
  • 6: Other (e.g., dental infection, STIs, gonorrhea, chlamydia, blood infection, sepsis, bone infection, osteomyelitis)
  • 8: RF
  • 9: DK

Antibiotic medication use (AMU) - Question identifier:AMU_Q020

(Thinking about this last oral antibiotic), was it prescribed at a...?

  • 1: Walk-in clinic or doctor's office
  • 2: Hospital as an outpatient (e.g., emergency ward or day clinic)
  • 3: Hospital while you were admitted
  • 4: Dentist's office
  • 5: Another place
  • 8: RF
  • 9: DK

Antibiotic medication use (AMU) - Question identifier:AMU_Q025

(Thinking about this last oral antibiotic) did you, or someone on your behalf, receive information from a health care professional, including a pharmacist, on how to take it?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Antibiotic medication use (AMU) - Question identifier:AMU_Q030

(Again, thinking about this last oral antibiotic), did you take it as prescribed?

  • 1: Yes (took it as prescribed)
  • 2: No (did not take it as prescribed)
  • 3: Not applicable (did not get prescription filled))
  • 4: Still taking it
  • 8: RF
  • 9: DK

Antibiotic medication use (AMU) - Question identifier:AMU_Q035

In what way did you not take it as prescribed?

  • 1: Incorrect daily dosage, such as missing a dose / taking too many or too few
  • 2: Did not finish it
  • 3: Another way
  • 4: Did not take it at all
  • 8: RF
  • 9: DK

Antibiotic medication use (AMU) - Question identifier:AMU_Q040

In the past 12 months, thinking of all the oral antibiotics you were prescribed, did you have any left?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Antibiotic medication use (AMU) - Question identifier:AMU_Q045

What did you do with them?

  • 1: Threw them in the garbage
  • 2: Flushed them down the toilet / sink
  • 3: Kept them / did nothing
  • 4: Gave them to someone else for their use
  • 5: Returned them to the pharmacy
  • 6: Other action
  • 8: RF
  • 9: DK

Cannabis use (CAN)

Cannabis use (CAN) - Question identifier:CAN_R005

The next few questions are about the use of cannabis for medical and non-medical purposes. The term "cannabis" refers to marijuana, hashish, hash oil or any other product of the cannabis plant.

Cannabis use (CAN) - Question identifier:CAN_Q005

Have you ever used or tried cannabis?

  • 1: Yes, just once
  • 2: Yes, more than once
  • 3: No
  • 8: RF
  • 9: DK

Cannabis use (CAN) - Question identifier:CAN_Q010

At what age did you first try cannabis?

Min = 5; Max = 121

Cannabis use (CAN) - Question identifier:CAN_Q015

Have you used cannabis in the past 12 months?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Cannabis use (CAN) - Question identifier:CAN_Q020

How often (did you use cannabis in the past 12 months)?

  • 1: Less than once a month
  • 2: 1 to 3 times a month
  • 3: Once a week
  • 4: More than once a week
  • 5: Daily or almost daily
  • 8: RF
  • 9: DK

Cannabis use (CAN) - Question identifier:CAN_Q025

In the past 12 months, which of the following methods did you use most often?

  • 1: Smoked
  • 2: Vaporized
  • 3: Consumed in food or drink
  • 4: Other - Specify
  • 8: RF
  • 9: DK

Cannabis use (CAN) - Question identifier:CAN_Q030

(In the past 12 months), have you used cannabis for...?

  • 1: Non-medical purposes only
  • 2: Medical purposes only, either with or without a medical document
  • 3: Both medical and non-medical purposes
  • 8: RF
  • 9: DK

Cannabis use (CAN) - Question identifier:CAN_Q035

In the past 12 months, when you used cannabis for medical purposes, which symptoms were you using it for?

  • 01: Pain
  • 02: Nausea / vomiting
  • 03: Lack of appetite / weight loss
  • 04: Headaches / migraines
  • 05: Muscle spasms or seizures
  • 06: Anxiety / depression
  • 07: Symptoms of PTSD
  • 08: Problems sleeping
  • 09: Opioid withdrawal symptoms
  • 10: Other - Specify
  • 98: RF
  • 99: DK

Cannabis use (CAN) - Question identifier:CAN_Q040

Do you have a medical document from a health care professional to use cannabis for medical purposes?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Cannabis use (CAN) - Question identifier:CAN_Q045

In the past 12 months, has your use of cannabis led to health, social, legal or financial problems?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Cannabis use (CAN) - Question identifier:CAN_Q050

At any time in the past 12 months, have you failed to do what was normally expected of you because of your use of cannabis?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Cannabis use (CAN) - Question identifier:CAN_Q055

(In the past 12 months), has a relative, friend, doctor or other health professional been concerned about your use of cannabis or suggested you cut down?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Cannabis use (CAN) - Question identifier:CAN_Q060

In the past 30 days, how often did you use cannabis?

  • 1: Never
  • 2: 1 day
  • 3: 2 or 3 days
  • 4: 1 or 2 day(s) per week
  • 5: 3 or 4 days per week
  • 6: 5 or 6 days per week
  • 7: Daily
  • 8: RF
  • 9: DK

Cannabis use (CAN) - Question identifier:CAN_Q065

At what age did you begin to use cannabis daily or almost daily?

Min = 5; Max = 121

Severity of cannabis dependence scale (SDS)

Severity of cannabis dependence scale (SDS) - Question identifier:SDS_R005

You may feel like some of the following questions do not apply to you; however, it is important that they be asked in this survey.

Severity of cannabis dependence scale (SDS) - Question identifier:SDS_Q005

In the past 12 months, how often do you think your use of cannabis was out of control?

  • 1: Never / almost never
  • 2: Sometimes
  • 3: Often
  • 4: Always / nearly always
  • 8: RF
  • 9: DK

Severity of cannabis dependence scale (SDS) - Question identifier:SDS_Q010

In the past 12 months, how often did the idea of missing a dose of cannabis make you anxious or worried?

  • 1: Never / almost never
  • 2: Sometimes
  • 3: Often
  • 4: Always / nearly always
  • 8: RF
  • 9: DK

Severity of cannabis dependence scale (SDS) - Question identifier:SDS_Q015

(In the past 12 months), how often did you worry about your use of cannabis?

  • 1: Never / almost never
  • 2: Sometimes
  • 3: Often
  • 4: Always / nearly always
  • 8: RF
  • 9: DK

Severity of cannabis dependence scale (SDS) - Question identifier:SDS_Q020

(In the last 12 months), how often did you wish you could stop using cannabis?

  • 1: Never / almost never
  • 2: Sometimes
  • 3: Often
  • 4: Always / nearly always
  • 8: RF
  • 9: DK

Severity of cannabis dependence scale (SDS) - Question identifier:SDS_Q025

How difficult would it be for you to stop or go without using cannabis?

  • 1: Not difficult
  • 2: Quite difficult
  • 3: Very difficult
  • 4: Impossible
  • 8: RF
  • 9: DK

Drug use (DRG)

Drug use (DRG) - Question identifier:DRG_R005

I am now going to ask questions on your use of various drugs.

Drug use (DRG) - Question identifier:DRG_Q020

Have you ever used or tried cocaine in any form, including crack, freebase, powder or snow?

  • 1: Yes, just once
  • 2: Yes, more than once
  • 3: No
  • 8: RF
  • 9: DK

Drug use (DRG) - Question identifier:DRG_Q025

Was this in the past 12 months?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Drug use (DRG) - Question identifier:DRG_Q030

Have you ever used or tried amphetamines, speed, methamphetamines or crystal meth?

  • 1: Yes, just once
  • 2: Yes, more than once
  • 3: No
  • 8: RF
  • 9: DK

Drug use (DRG) - Question identifier:DRG_Q035

Was this in the past 12 months?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Drug use (DRG) - Question identifier:DRG_Q040

Have you ever used or tried ecstasy, also known as MDMA, E, Xtc, Adam or X?

  • 1: Yes, just once
  • 2: Yes, more than once
  • 3: No
  • 8: RF
  • 9: DK

Drug use (DRG) - Question identifier:DRG_Q045

Was this in the past 12 months?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Drug use (DRG) - Question identifier:DRG_Q050

Have you ever used or tried hallucinogens such as PCP, LSD, acid, magic mushrooms, mescaline or angel dust?

  • 1: Yes, just once
  • 2: Yes, more than once
  • 3: No
  • 8: RF
  • 9: DK

Drug use (DRG) - Question identifier:DRG_Q055

Was this in the past 12 months?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Drug use (DRG) - Question identifier:DRG_Q060

Have you ever sniffed glue, gasoline or other solvents to get high?

  • 1: Yes, just once
  • 2: Yes, more than once
  • 3: No
  • 8: RF
  • 9: DK

Drug use (DRG) - Question identifier:DRG_Q065

Was this in the past 12 months?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Drug use (DRG) - Question identifier:DRG_Q070

Have you ever used a needle to inject or be injected with a drug not prescribed by a doctor?

  • 1: Yes, just once
  • 2: Yes, more than once
  • 3: No
  • 8: RF
  • 9: DK

Drug use (DRG) - Question identifier:DRG_Q075

Was this in the past 12 months?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Drug use (DRG) - Question identifier:DRG_Q080

Which of the following drugs have you injected using a needle?

  • 1: Cocaine
  • 2: Heroin or opium
  • 3: Methamphetamine
  • 4: Steroids
  • 5: Other
  • 6: I have never injected a drug using a needle
  • 8: RF
  • 9: DK

Gambling (GAM)

Gambling (GAM) - Question identifier:GAM_R001

The following questions are about various types of gambling activities. Please think about all forms of gambling done either in person or online, including lotteries, organized betting and casual wagers with friends.

Gambling (GAM) - Question identifier:GAM_Q005

In the past 12 months, how often have you purchased or played instant lottery tickets, such as scratch, break-open or pull-tabs, or played instant online games?

  • 1: Never
  • 2: Less than once a month
  • 3: Once a month
  • 4: Two or three times a month
  • 5: Once a week
  • 6: Several times a week
  • 8: RF
  • 9: DK

Gambling (GAM) - Question identifier:GAM_Q010

And how often have you played or spent money on lottery or raffle tickets, excluding sports lottery tickets (in the past 12 months)?

  • 1: Never
  • 2: Less than once a month
  • 3: Once a month
  • 4: Two or three times a month
  • 5: Once a week
  • 6: Several times a week
  • 8: RF
  • 9: DK

Gambling (GAM) - Question identifier:GAM_Q015

In the past 12 months, how often have you bet or spent money on electronic gambling machines, such as slot machines, VLTs, electronic blackjack, electronic roulette or video poker, either in person or online?

  • 1: Never
  • 2: Less than once a month
  • 3: Once a month
  • 4: Two or three times a month
  • 5: Once a week
  • 6: Several times a week
  • 8: RF
  • 9: DK

Gambling (GAM) - Question identifier:GAM_Q020

Now, excluding electronic machine versions, how often in the past 12 months have you bet or spent money on casino table games like poker, blackjack, baccarat, or roulette? Please include any location, whether at a casino, a private residence, online or anywhere else.

  • 1: Never
  • 2: Less than once a month
  • 3: Once a month
  • 4: Two or three times a month
  • 5: Once a week
  • 6: Several times a week
  • 8: RF
  • 9: DK

Gambling (GAM) - Question identifier:GAM_Q025

In the past 12 months, how often have you bet money on sports such as hockey, football, horseracing, billiards or golf including pools, sports lottery, and bets made with friends?

  • 1: Never
  • 2: Less than once a month
  • 3: Once a month
  • 4: Two or three times a month
  • 5: Once a week
  • 6: Several times a week
  • 8: RF
  • 9: DK

Gambling (GAM) - Question identifier:GAM_Q030

In the past 12 months, how often have you spent money playing Bingo, excluding instant Bingo games?

  • 1: Never
  • 2: Less than once a month
  • 3: Once a month
  • 4: Two or three times a month
  • 5: Once a week
  • 6: Several times a week
  • 8: RF
  • 9: DK

Gambling (GAM) - Question identifier:GAM_Q035

How often in the past 12 months have you bet or spent money on any other forms of gambling that have not been mentioned?

  • 1: Never
  • 2: Less than once a month
  • 3: Once a month
  • 4: Two or three times a month
  • 5: Once a week
  • 6: Several times a week
  • 8: RF
  • 9: DK

Gambling (GAM) - Question identifier:GAM_Q040

In the past 12 months, how often have you engaged in any speculative financial market activities such as day trading, penny stocks, shorting, options, currency futures, etc.?

  • 1: Never
  • 2: Less than once a month
  • 3: Once a month
  • 4: Two or three times a month
  • 5: Once a week
  • 6: Several times a week
  • 8: RF
  • 9: DK

Gambling (GAM) - Question identifier:GAM_Q045

For the types of gambling that you reported participating in, has your involvement been in-person, online, or both?

  • 1: Online
  • 2: In person
  • 3: Both
  • 8: RF
  • 9: DK

Gambling (GAM) - Question identifier:GAM_R050

You may feel like some of the following questions do not apply to you; however, it is important that they are asked in this survey.

Gambling (GAM) - Question identifier:GAM_Q050

In the past 12 months, how often have you bet more than you could really afford to lose?

  • 1: Never
  • 2: Sometimes
  • 3: Most of the time
  • 4: Almost always
  • 8: RF
  • 9: DK

Gambling (GAM) - Question identifier:GAM_Q055

In the past 12 months, how often have you needed to gamble with larger amounts of money to get the same feeling of excitement?

  • 1: Never
  • 2: Sometimes
  • 3: Most of the time
  • 4: Almost always
  • 8: RF
  • 9: DK

Gambling (GAM) - Question identifier:GAM_Q060

(In the past 12 months), when you gambled, how often did you go back another day to try to win back the money you lost?

  • 1: Never
  • 2: Sometimes
  • 3: Most of the time
  • 4: Almost always
  • 8: RF
  • 9: DK

Gambling (GAM) - Question identifier:GAM_Q065

(In the past 12 months), have you borrowed money or sold anything to get money to gamble?

  • 1: Never
  • 2: Sometimes
  • 3: Most of the time
  • 4: Almost always
  • 8: RF
  • 9: DK

Gambling (GAM) - Question identifier:GAM_Q070

(In the past 12 months), how often has your gambling caused any financial problems for you or your household?

  • 1: Never
  • 2: Sometimes
  • 3: Most of the time
  • 4: Almost always
  • 8: RF
  • 9: DK

Gambling (GAM) - Question identifier:GAM_Q075

(In the past 12 months), how often have you felt that you might have a problem with gambling?

  • 1: Never
  • 2: Sometimes
  • 3: Most of the time
  • 4: Almost always
  • 8: RF
  • 9: DK

Gambling (GAM) - Question identifier:GAM_Q080

(In the past 12 months), how often has your gambling caused you any health problems, including stress or anxiety?

  • 1: Never
  • 2: Sometimes
  • 3: Most of the time
  • 4: Almost always
  • 8: RF
  • 9: DK

Gambling (GAM) - Question identifier:GAM_Q085

(In the past 12 months), how often have people criticized your betting or told you that you had a gambling problem, regardless of whether or not you thought it was true?

  • 1: Never
  • 2: Sometimes
  • 3: Most of the time
  • 4: Almost always
  • 8: RF
  • 9: DK

Gambling (GAM) - Question identifier:GAM_Q090

(In the past 12 months), how often have you felt guilty about the way you gamble or what happens when you gamble?

  • 1: Never
  • 2: Sometimes
  • 3: Most of the time
  • 4: Almost always
  • 8: RF
  • 9: DK

Physical activities - adults 18 years and older (PAA)

Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_R001

The following questions are about various types of physical activities done in the last 7 days. I want you to only think of activities you did for a minimum of 10 continuous minutes.

Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q005

In the last 7 days, that is from last [Day of the week 7 days ago] to yesterday, did you use active ways like walking or cycling to get to places such as work, school, the bus stop, the shopping centre or to visit friends?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q010

In the last 7 days, on which days did you do these activities?

  • 1: Monday
  • 2: Tuesday
  • 3: Wednesday
  • 4: Thursday
  • 5: Friday
  • 6: Saturday
  • 7: Sunday
  • 8: RF
  • 9: DK

Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q015

How much time in total, in the last 7 days, did you spend doing these activities? Please only include activities that lasted a minimum of 10 continuous minutes.

Min = 0; Max = 168

Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_N020

Enter number of minutes.

Min = 0; Max = 9995

Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q030

[Not including activities you just reported,] in the last 7 days, did you do sports, fitness or recreational physical activities, organized or non-organized, that lasted a minimum of 10 continuous minutes?

Examples are walking, home or gym exercise, swimming, cycling, running, skiing, dancing and all team sports.

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q035

Did any of these recreational physical activities make you sweat at least a little and breathe harder?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q040

In the last 7 days, on which days did you do these recreational activities that made you sweat at least a little and breathe harder?

  • 1: Monday
  • 2: Tuesday
  • 3: Wednesday
  • 4: Thursday
  • 5: Friday
  • 6: Saturday
  • 7: Sunday
  • 8: RF
  • 9: DK

Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q045

In the last 7 days, how much time in total did you spend doing these activities that made you sweat at least a little and breathe harder?

Min = 0; Max = 168

Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_N050

Enter number of minutes.

Min = 0; Max = 9995

Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q060

In the last 7 days, did you do any other physical activities while at work, in or around your home or while volunteering?

Examples are carrying heavy loads, shoveling, and household chores such as vacuuming or washing windows. Please remember to only include activities that lasted a minimum of 10 continuous minutes.

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q065

Did any of these other physical activities make you sweat at least a little and breathe harder?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q070

In the last 7 days, on which days did you do these other activities that made you sweat at least a little and breathe harder?

  • 1: Monday
  • 2: Tuesday
  • 3: Wednesday
  • 4: Thursday
  • 5: Friday
  • 6: Saturday
  • 7: Sunday
  • 8: RF
  • 9: DK

Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q075

In the last 7 days, how much time in total did you spend doing these activities that made you sweat at least a little and breathe harder?

Min = 0; Max = 168

Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_N080

Enter number of minutes.

Min = 0; Max = 9995

Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q095

You have reported a total of [Total number of minutes] minutes of physical activity. Of these activities, were there any of vigorous intensity, meaning they caused you to be out of breath?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q100

In the last 7 days, how much time in total did you spend doing vigorous activities that caused you to be out of breath?

Min = 0; Max = 168

Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_N105

Enter number of minutes.

Min = 0; Max = 9995

Physical activities for youth (PAY)

Physical activities for youth (PAY) - Question identifier:PAY_R001

The following questions are about various types of physical activities that you have done each day in the past week.

Physical activities for youth (PAY) - Question identifier:PAY_Q005

During the last 7 days, that is from last [Day of the week 7 days ago] to yesterday, did you...?

  • 1: Attend school
  • 2: Attend a day camp
  • 3: Attend paid or unpaid work
  • 4: None of the above
  • 8: RF
  • 9: DK

Physical activities for youth (PAY) - Question identifier:PAY_Q010

In the last 7 days, did you use active ways like walking or cycling to get to places such [school,] the bus stop, the shopping centre, [work] or to visit friends?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Physical activities for youth (PAY) - Question identifier:PAY_Q015

How much time did you spend using active ways to get to places...
...yesterday?
...on [2 days ago]?
...on [3 days ago]?
...on [4 days ago]?
...on [5 days ago]?
...on [6 days ago]?
...on [7 days ago]?

Min = 0; Max = 10080

Physical activities for youth (PAY) - Question identifier:PAY_Q025

In the last 7 days, did you do sports, fitness or recreational physical activities while at [school [or day camp], including during physical education classes, during your breaks and any other time you played indoors or outdoors / day camp, including any time you played indoors or outdoors]?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Physical activities for youth (PAY) - Question identifier:PAY_Q030

Did any of these activities make you sweat at least a little and breathe harder?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Physical activities for youth (PAY) - Question identifier:PAY_Q035

How much time did you spend doing these activities at [school / day camp / school or day camp] that made you sweat at least a little and breathe harder...
...yesterday?
...on [2 days ago]?
...on [3 days ago]?
...on [4 days ago]?
...on [5 days ago]?
...on [6 days ago]?
...on [7 days ago]?

Min = 0; Max = 10080

Physical activities for youth (PAY) - Question identifier:PAY_Q045

In the last 7 days, did you do physical activities in your leisure time including exercising, playing an organized or non-organized sport or playing with your friends?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Physical activities for youth (PAY) - Question identifier:PAY_Q050

Did any of these leisure-time activities make you sweat at least a little and breathe harder?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Physical activities for youth (PAY) - Question identifier:PAY_Q055

How much time did you spend doing these leisure-time activities that made you sweat at least a little and breathe harder...
...yesterday?
...on [2 days ago]?
...on [3 days ago]?
...on [4 days ago]?
...on [5 days ago]?
...on [6 days ago]?
...on [7 days ago]?

Min = 0; Max = 10080

Physical activities for youth (PAY) - Question identifier:PAY_Q065

In the last 7 days, did you do any other physical activities [that you have not already reported], for example, while you were [doing paid or unpaid work or] helping your family with chores?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Physical activities for youth (PAY) - Question identifier:PAY_Q070

Did any of these other physical activities make you sweat at least a little and breathe harder?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Physical activities for youth (PAY) - Question identifier:PAY_Q075

How much time did you spend doing these other physical activities that made you sweat at least a little and breathe harder...
...yesterday?
...on [2 days ago]?
...on [3 days ago]?
...on [4 days ago]?
...on [5 days ago]?
...on [6 days ago]?
...on [7 days ago]?

Min = 0; Max = 10080

Physical activities for youth (PAY) - Question identifier:PAY_Q090

You have reported a total of [Total number of minutes] minutes of physical activity. Of these activities, were there any of vigorous intensity, meaning they caused you to be out of breath?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Physical activities for youth (PAY) - Question identifier:PAY_Q095

In the last 7 days, on which days did you do these vigorous activities that caused you to be out of breath?

  • 1: Yesterday
  • 2: [2 days ago]
  • 3: [3 days ago]
  • 4: [4 days ago]
  • 5: [5 days ago]
  • 6: [6 days ago]
  • 7: [7 days ago]
  • 8: RF
  • 9: DK

Physical activities for youth (PAY) - Question identifier:PAY_Q100

In the last 7 days, how much time in total did you spend doing vigorous activities that caused you to be out of breath?

Min = 0; Max = 168

Physical activities for youth (PAY) - Question identifier:PAY_N105

Enter number of minutes.

Min = 0; Max = 9995

Sedentary behaviours (SBE)

Sedentary behaviours (SBE) - Question identifier:SBE_R001

The next questions are about the time you spent sitting in the last 7 days.

Sedentary behaviours (SBE) - Question identifier:SBE_Q005

On a school or work day, how much of your free time did you spend watching television or a screen on any electronic device while sitting or lying down?

  • 1: 2 hours or less per day
  • 2: More than 2 hours but less than 4 hours
  • 3: 4 hours to less than 6 hours
  • 4: 6 hours to less than 8 hours
  • 5: 8 hours or more per day
  • 6: Was not at work or school
  • 8: RF
  • 9: DK

Sedentary behaviours (SBE) - Question identifier:SBE_Q010

On a day that was not a school or workday, how much of your free time did you spend watching television or a screen on any electronic device while sitting or lying down?

  • 1: 2 hours or less per day
  • 2: More than 2 hours but less than 4 hours
  • 3: 4 hours to less than 6 hours
  • 4: 6 hours to less than 8 hours
  • 5: 8 hours or more per day
  • 8: RF
  • 9: DK

Sexual behaviours (SXB)

Sexual behaviours (SXB) - Question identifier:SXB_R001

The next questions are about sexual behaviours. Some questions may sound sensitive to you, but they are included in this survey because they will help monitor important public health issues such as risk of sexually transmitted infections and unintended pregnancies.

Sexual behaviours (SXB) - Question identifier:SXB_Q005

Have you ever had sex? Please include vaginal and anal sex.

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Sexual behaviours (SXB) - Question identifier:SXB_Q030

In the past 12 months, have you had sex with a female?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Sexual behaviours (SXB) - Question identifier:SXB_Q060

In the past 12 months, have you had sex with a male?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Sexual behaviours (SXB) - Question identifier:SXB_Q075

Was your last sex partner a male or female?

  • 1: Male
  • 2: Female
  • 3: Both male and female (at same time)
  • 8: RF
  • 9: DK

Sexual behaviours (SXB) - Question identifier:SXB_Q080

Did you or your partner use a condom the last time you had sex?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Sexual behaviours (SXB) - Question identifier:SXB_Q095

What other methods of protection did you and your partner use the last time you had sex?

  • 01: Withdrawal or pulling out
  • 02: Vasectomy or tubal sterilization ("tubes tied")
  • 03: Birth control pill
  • 04: Injection (e.g., Depo-Provera¿)
  • 05: Spermicidal foam, jelly, cream, film, suppository
  • 06: Hormonal implant
  • 07: Rhythm method (tracking ovulation cycle)
  • 08: Contraceptive Patch (e.g., Ortho-Evra¿)
  • 09: Vaginal contraceptive ring (e.g., Nuva-ring¿)
  • 10: Intrauterine Device (IUD) (e.g., Mirena¿), coil, loop
  • 11: None
  • 12: Other - Specify
  • 98: RF
  • 99: DK

Sexual behaviours (SXB) - Question identifier:SXB_R150

I'm going to read you a statement about pregnancy. Please tell me if you strongly agree, agree, neither agree nor disagree, disagree, or strongly disagree.

Sexual behaviours (SXB) - Question identifier:SXB_Q150

It is important to me to avoid getting pregnant right now.

  • 1: Strongly agree
  • 2: Agree
  • 3: Neither agree nor disagree
  • 4: Disagree
  • 5: Strongly disagree
  • 8: RF
  • 9: DK

Maternal experiences (MEX)

Maternal experiences (MEX) - Question identifier:MEX_R001

The next questions are specific to women's health.

Maternal experiences (MEX) - Question identifier:MEX_Q005

Are you taking a vitamin supplement containing folic acid?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Maternal experiences (MEX) - Question identifier:MEX_Q010

Have you given birth in the past 5 years?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Maternal experiences (MEX) - Question identifier:MEX_Q015

What is the name of your last born child?

Long Answer Length = 50

Maternal experiences (MEX) - Question identifier:MEX_Q020

What is [your last child]'s date of birth?

Min = 1; Max = 31

Maternal experiences (MEX) - Question identifier:MEX_Q025

What is [your last child]'s date of birth?

  • 01: January
  • 02: February
  • 03: March
  • 04: April
  • 05: May
  • 06: June
  • 07: July
  • 08: August
  • 09: September
  • 10: October
  • 11: November
  • 12: December
  • 98: RF
  • 99: DK

Maternal experiences (MEX) - Question identifier:MEX_Q030

What is [your last child]'s date of birth?

Min = 2010; Max = 2099

Maternal experiences (MEX) - Question identifier:MEX_R040

The next questions are about your maternal experiences related to [your last child].

Maternal experiences (MEX) - Question identifier:MEX_Q040

In the three months before you got pregnant with [your last child], did you take a folic acid supplement or a multivitamin containing folic acid?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Maternal experiences (MEX) - Question identifier:MEX_Q045

Did you take it every day or almost every day?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Maternal experiences (MEX) - Question identifier:MEX_Q050

During the first three months of your pregnancy (with [your last child]), did you take a folic acid supplement or a multivitamin containing folic acid?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Maternal experiences (MEX) - Question identifier:MEX_Q055

Did you take it every day or almost every day?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Maternal experiences (MEX) - Question identifier:MEX_Q060

Before your pregnancy (with [your last child]), were you aware that taking folic acid before becoming pregnant can help prevent some birth defects?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Maternal experiences (MEX) - Question identifier:MEX_Q065

During your pregnancy (with [your last child]), did you take a vitamin supplement containing iron?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Maternal experiences (MEX) - Question identifier:MEX_Q070

Just before your pregnancy (with [your last child]), how much did you weigh?

Min = 1; Max = 700

Maternal experiences (MEX) - Question identifier:MEX_N075

Was that in pounds or kilograms?

  • 1: Pounds
  • 2: Kilograms

Maternal experiences (MEX) - Question identifier:MEX_Q080

How much weight did you gain during that pregnancy?

Min = -50; Max = 199

Maternal experiences (MEX) - Question identifier:MEX_N085

Was that in pounds or kilograms?

  • 1: Pounds
  • 2: Kilograms

Maternal experiences (MEX) - Question identifier:MEX_Q090

[How often does [your last child]/When [your last child] was less than one year old, how often did he/she] sleep in the same bed with you or anyone else?

  • 1: Every day or almost every day
  • 2: Once or twice a week
  • 3: A few times a month
  • 4: Less than once a month
  • 5: Never
  • 8: RF
  • 9: DK

Maternal experiences (MEX) - Question identifier:MEX_Q095

What is the main reason [your last child] [is/was] sleeping in the same bed with you or someone else?

  • 1: To breastfeed
  • 2: So the baby would sleep / So I could get some sleep
  • 3: Did not have room for a crib
  • 4: Could not afford a crib
  • 5: Believe that bedsharing was best for my child
  • 6: Child was sick
  • 7: Other
  • 8: RF
  • 9: DK

Maternal experiences (MEX) - Question identifier:MEX_Q100

Was [your last child] breastfed or given breast milk even for a short time?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Maternal experiences (MEX) - Question identifier:MEX_Q105

What is the main reason that you did not breastfeed or give breast milk?

  • 1: Bottle feeding is easier
  • 2: Formula is as good as breast milk
  • 3: Breastfeeding is unappealing
  • 4: Medical condition - mother
  • 5: Other - Specify
  • 8: RF
  • 9: DK

Maternal experiences (MEX) - Question identifier:MEX_Q110

Are you still breastfeeding or giving breast milk to [your last child]?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Maternal experiences (MEX) - Question identifier:MEX_Q115

How long did you breastfeed or give breast milk to [your last child]?

Min = 1; Max = 730

Maternal experiences (MEX) - Question identifier:MEX_N115A

Was this time in days, weeks, months or years?

  • 1: Days
  • 2: Weeks
  • 3: Months
  • 4: Years

Maternal experiences (MEX) - Question identifier:MEX_Q120

What is the main reason that you stopped breastfeeding or giving breast milk?

  • 01: Not enough breast milk
  • 02: Baby was ready for solid foods
  • 03: Inconvenience / fatigue due to breastfeeding
  • 04: Difficulty with breastfeeding (e.g., sore nipples, engorged breasts, mastitis)
  • 05: Medical condition - mother
  • 06: Medical condition - baby
  • 07: Planned to stop at this time
  • 08: Child weaned him / herself (e.g., baby refusing breast, lack of interest)
  • 09: Returned to work / school
  • 10: Other - Specify
  • 98: RF
  • 99: DK

Maternal experiences (MEX) - Question identifier:MEX_Q125

[Are you giving [your last child] a vitamin D supplement? / When [your last child] was [less than a year old / less than one year old and fed breast milk / fed breast milk], did you give him/her a vitamin D supplement?]

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Maternal experiences (MEX) - Question identifier:MEX_Q130

[Now that [your last child] is more than a year old, are you still giving [him/her] a vitamin D supplement?/When [your last child] was older than one and fed breast milk, did you continue to give [him/her] a vitamin D supplement?]

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Maternal experiences (MEX) - Question identifier:MEX_Q140

Overall, how often [do / did] you give [your last child] a supplement containing vitamin D?

  • 1: Every day
  • 2: Almost every day
  • 3: Once or twice a week
  • 4: Less than once a week
  • 8: RF
  • 9: DK

Maternal experiences (MEX) - Question identifier:MEX_Q150

[While you were still breastfeeding, had / Have] liquids such as milk, formula, water, juice, tea or herbal mixture been introduced to [your last child]'s feeds?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Maternal experiences (MEX) - Question identifier:MEX_Q155

How old was your last child when other liquids were first added to the feeds?

Min = 1; Max = 730

Maternal experiences (MEX) - Question identifier:MEX_N160

Was this time in days, weeks, months or years?

  • 1: Days
  • 2: Weeks
  • 3: Months
  • 4: Years

Maternal experiences (MEX) - Question identifier:MEX_Q170

Have solid foods such as cereals, mashed up or pureed meat, vegetables or fruits been introduced to the baby's feeds?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Maternal experiences (MEX) - Question identifier:MEX_Q175

How old was [your last child] when solid foods (such as cereals, mashed up or pureed meat, vegetables or fruits) were first added to their feeds?

Min = 1; Max = 730

Maternal experiences (MEX) - Question identifier:MEX_N180

Was this time in days, weeks, months or years?

  • 1: Days
  • 2: Weeks
  • 3: Months
  • 4: Years

Maternal experiences (MEX) - Question identifier:MEX_Q190

What was the first solid food added to [your last child]'s feeds?

  • 1: Infant cereals
  • 2: Meat, fish or poultry
  • 3: Meat alternatives (includes eggs, tofu, legumes, peas or lentils)
  • 4: Fruits or vegetables
  • 5: Other
  • 8: RF
  • 9: DK

Maternal experiences (MEX) - Question identifier:MEX_Q195

What is the main reason [other liquids / solid foods / other liquids and solid foods] were first added to [your last child]'s feeds?

  • 01: Not enough breast milk
  • 02: [Baby was ready for solid foods]
  • 03: Inconvenience / fatigue due to breastfeeding
  • 04: Difficulty with breastfeeding (e.g., sore nipples, engorged breasts, mastitis)
  • 05: Medical condition - mother
  • 06: Medical condition - baby
  • 07: Advice from health professional / family
  • 08: Returned to work / school
  • 09: Formula equally healthy for baby
  • 10: Other - Specify
  • 98: RF
  • 99: DK

Smoking during maternal experience (MXS)

Smoking during maternal experience (MXS) - Question identifier:MXS_Q005

In the three months before your pregnancy with [your last child], or before you realized you were pregnant, did you smoke cigarettes?

  • 1: Everyday
  • 2: Almost everyday
  • 3: About 2 or 3 times a week
  • 4: About once a week
  • 5: Once or twice
  • 6: Never
  • 8: RF
  • 9: DK

Smoking during maternal experience (MXS) - Question identifier:MXS_Q010

Once you found out you were pregnant (with [your last child]), did you smoke?

  • 1: Everyday
  • 2: Almost everyday
  • 3: About 2 or 3 times a week
  • 4: About once a week
  • 5: Once or twice
  • 6: Never
  • 8: RF
  • 9: DK

Smoking during maternal experience (MXS) - Question identifier:MXS_Q015

During the last 3 months of your pregnancy (with [your last child]), did you smoke?

  • 1: Everyday
  • 2: Almost everyday
  • 3: About 2 or 3 times a week
  • 4: About once a week
  • 5: Once or twice
  • 6: Never
  • 8: RF
  • 9: DK

Smoking during maternal experience (MXS) - Question identifier:MXS_Q020

Did anyone regularly smoke in your presence during your pregnancy with [your last child]?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Alcohol use during maternal experience (MXA)

Alcohol use during maternal experience (MXA) - Question identifier:MXA_Q005

In the three months before your pregnancy with [your last child], or before you realized you were pregnant, did you drink any alcohol?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Alcohol use during maternal experience (MXA) - Question identifier:MXA_Q010

How often did you drink?

  • 1: Less than once per month
  • 2: Once per month
  • 3: 2 to 3 times per month
  • 4: Once a week
  • 5: 2 to 3 times per week
  • 6: 4 to 6 times per week
  • 7: Everyday
  • 8: RF
  • 9: DK

Alcohol use during maternal experience (MXA) - Question identifier:MXA_Q015

Once you found out you were pregnant with [your last child], did you drink any alcohol?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Alcohol use during maternal experience (MXA) - Question identifier:MXA_Q020

How often did you drink?

  • 1: Less than once per month
  • 2: Once per month
  • 3: 2 to 3 times per month
  • 4: Once a week
  • 5: 2 to 3 times per week
  • 6: 4 to 6 times per week
  • 7: Everyday
  • 8: RF
  • 9: DK

Alcohol use during maternal experience (MXA) - Question identifier:MXA_Q025

During the last 3 months of your pregnancy (with [your last child]), did you drink any alcohol?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Alcohol use during maternal experience (MXA) - Question identifier:MXA_Q030

How often did you drink?

  • 1: Less than once per month
  • 2: Once per month
  • 3: 2 to 3 times per month
  • 4: Once a week
  • 5: 2 to 3 times per week
  • 6: 4 to 6 times per week
  • 7: Everyday
  • 8: RF
  • 9: DK

Alcohol use during maternal experience (MXA) - Question identifier:MXA_Q035

While you were breastfeeding ([your last child]), did you drink any alcohol?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Alcohol use during maternal experience (MXA) - Question identifier:MXA_Q040

How often did you drink?

  • 1: Less than once per month
  • 2: Once per month
  • 3: 2 to 3 times per month
  • 4: Once a week
  • 5: 2 to 3 times per week
  • 6: 4 to 6 times per week
  • 7: Everyday
  • 8: RF
  • 9: DK

Driving and safety (DRV)

Driving and safety (DRV) - Question identifier:DRV_R001

The next questions are about the use of a motor vehicle.

Driving and safety (DRV) - Question identifier:DRV_Q005

In the past 12 months, excluding motorcycles and off-road vehicles, have you driven a motor vehicle such as a car, truck or a van?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Driving and safety (DRV) - Question identifier:DRV_Q010

In the past 12 months, how often did you use a hands-free device such as Bluetooth when talking on the cell phone while driving a motor vehicle?

  • 1: Often
  • 2: Sometimes
  • 3: Rarely
  • 4: Never
  • 5: Does not possess or have access to a cell phone
  • 8: RF
  • 9: DK

Driving and safety (DRV) - Question identifier:DRV_Q015

In the past 12 months, excluding hands-free use, how often did you talk on a cell phone while driving a motor vehicle?

  • 1: Often
  • 2: Sometimes
  • 3: Rarely
  • 4: Never
  • 5: Does not possess or have access to a cell phone
  • 8: RF
  • 9: DK

Driving and safety (DRV) - Question identifier:DRV_Q020

In the past 12 months, how often did you text on a cell phone while driving a motor vehicle?

  • 1: Often
  • 2: Sometimes
  • 3: Rarely
  • 4: Never
  • 5: Does not possess or have access to a cell phone
  • 8: RF
  • 9: DK

Driving and safety (DRV) - Question identifier:DRV_Q025

In the past 12 months, how often did you use a cell phone for any other reason while driving a motor vehicle, for example, to send or receive emails, use social media, look at maps, etc.?

  • 1: Often
  • 2: Sometimes
  • 3: Rarely
  • 4: Never
  • 5: Does not possess or have access to a cell phone
  • 8: RF
  • 9: DK

Driving and safety (DRV) - Question identifier:DRV_Q030

In the past 12 months, have you driven a motorcycle?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Driving and safety (DRV) - Question identifier:DRV_Q035

In the past 12 months, how often did you drive [any vehicule] when you were feeling tired?

  • 1: Often
  • 2: Sometimes
  • 3: Rarely
  • 4: Never
  • 8: RF
  • 9: DK

Driving and safety (DRV) - Question identifier:DRV_Q070

In the past 12 months, have you been the driver of, or a passenger on, an ATV (all-terrain vehicle) or a snowmobile?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Driving and safety (DRV) - Question identifier:DRV_Q075

How often do you wear a helmet when on an ATV or a snowmobile?

  • 1: Always
  • 2: Most of the time
  • 3: Rarely
  • 4: Never
  • 8: RF
  • 9: DK

Driving while under the influence (DWI)

Driving while under the influence (DWI) - Question identifier:DWI_R005

The next questions are about motor vehicles driven after using alcohol or cannabis.

Driving while under the influence (DWI) - Question identifier:DWI_Q005

During the past 12 months, have you been a passenger in a motor vehicle driven by someone who had two or more drinks of alcohol in the previous 2 hours?

  • 1: Yes, once
  • 2: Yes, more than once
  • 3: No
  • 8: RF
  • 9: DK

Driving while under the influence (DWI) - Question identifier:DWI_Q010

During the past 12 months, have you been a passenger in a motor vehicle driven by someone who had been using cannabis in the previous 2 hours?

  • 1: Yes, once
  • 2: Yes, more than once
  • 3: No
  • 8: RF
  • 9: DK

Driving while under the influence (DWI) - Question identifier:DWI_Q015

During the past 12 months, have you been a passenger in a motor vehicle driven by someone who had been using both alcohol and cannabis in the previous 2 hours?

  • 1: Yes, once
  • 2: Yes, more than once
  • 3: No
  • 8: RF
  • 9: DK

Driving while under the influence (DWI) - Question identifier:DWI_Q020

During the past 12 months, have you driven a motor vehicle such as a car, motorbike, van or truck?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Driving while under the influence (DWI) - Question identifier:DWI_Q025

During the past 12 months, have you driven a motor vehicle after having 2 or more drinks in the previous 2 hours?

  • 1: Yes, once
  • 2: Yes, more than once
  • 3: No
  • 8: RF
  • 9: DK

Driving while under the influence (DWI) - Question identifier:DWI_Q030

During the past 12 months, have you driven a motor vehicle within 2 hours of using cannabis?

  • 1: Yes, once
  • 2: Yes, more than once
  • 3: No
  • 8: RF
  • 9: DK

Driving while under the influence (DWI) - Question identifier:DWI_Q035

During the past 12 months, have you driven a motor vehicle after using both alcohol and cannabis in the previous 2 hours?

  • 1: Yes, once
  • 2: Yes, more than once
  • 3: No
  • 8: RF
  • 9: DK

Flu shots (FLU)

Flu shots (FLU) - Question identifier:FLU_R001

Now a few questions about your use of various health care services.

Flu shots (FLU) - Question identifier:FLU_Q005

Have you ever had a seasonal flu shot, excluding the H1N1 flu shot?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Flu shots (FLU) - Question identifier:FLU_Q010

When did you have your last seasonal flu shot?

  • 1: Less than 1 year ago
  • 2: 1 year to less than 2 years ago
  • 3: 2 years ago or more
  • 8: RF
  • 9: DK

Flu shots (FLU) - Question identifier:FLU_Q015

In which month did you have your last seasonal flu shot?

  • 01: January
  • 02: February
  • 03: March
  • 04: April
  • 05: May
  • 06: June
  • 07: July
  • 08: August
  • 09: September
  • 10: October
  • 11: November
  • 12: December
  • 98: RF
  • 99: DK

Flu shots (FLU) - Question identifier:FLU_Q020

Was that this year or last year?

  • 1: This year
  • 2: Last year
  • 8: RF
  • 9: DK

Flu shots (FLU) - Question identifier:FLU_Q025

What are the reasons that you have not had a seasonal flu shot in the past year?

  • 01: Lack of time
  • 02: Respondent - did not think it was necessary
  • 03: Doctor - did not think it was necessary
  • 04: Not available - at time required
  • 05: Did not know where to go / uninformed
  • 06: Feelings of fear or discomfort
  • 07: Bad reaction to previous flu shot
  • 08: Bad reaction to previous vaccine other than flu shot
  • 09: Unsure of / does not believe in benefits of vaccine
  • 10: Does not want vaccine for fear of what it contains
  • 11: Other
  • 98: RF
  • 99: DK

Blood pressure check (BPC)

Blood pressure check (BPC) - Question identifier:BPC_R001

Now, a few questions about blood pressure measurement.

Blood pressure check (BPC) - Question identifier:BPC_Q005

Have you ever had your blood pressure measured by a health professional?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Blood pressure check (BPC) - Question identifier:BPC_Q010

When was the last time you had your blood pressure measured (by a health professional)?

  • 1: Less than 1 year to 1 year ago
  • 2: More than 1 year to 2 years ago
  • 3: More than 2 years to 3 years ago
  • 4: More than 3 years to 5 years ago
  • 5: More than 5 years ago
  • 8: RF
  • 9: DK

Blood pressure check (BPC) - Question identifier:BPC_Q015

What are the reasons that you have not had your blood pressure measured (by a health professional) in the past 2 years?

  • 1: Lack of time
  • 2: Respondent did not think it was necessary
  • 3: Doctor did not think it was necessary
  • 4: Feelings of fear or discomfort
  • 5: Don't have a doctor
  • 6: Other
  • 8: RF
  • 9: DK

Blood pressure check (BPC) - Question identifier:BPC_Q020

Were you pregnant the last time your blood pressure was measured (by a health professional)?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Pap smear test (PAP)

Pap smear test (PAP) - Question identifier:PAP_Q005

Have you ever had a Pap smear test?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Pap smear test (PAP) - Question identifier:PAP_Q010

When was the last time?

  • 1: Less than 1 year to 1 year ago
  • 2: More than 1 year to 2 years ago
  • 3: More than 2 years to 3 years ago
  • 4: More than 3 years to 5 years ago
  • 5: More than 5 years ago
  • 8: RF
  • 9: DK

Pap smear test (PAP) - Question identifier:PAP_Q015

What are the reasons that you have not had a Pap smear test in the past 3 years?

  • 1: Lack of time
  • 2: Respondent did not think it was necessary
  • 3: Doctor did not think it was necessary/ he never brought it up
  • 4: Feelings of fear or discomfort
  • 5: Don't have a doctor
  • 6: [Had a complete hysterectomy]
  • 7: Other
  • 8: RF
  • 9: DK

Pap smear test (PAP) - Question identifier:PAP_Q020

How often do you usually have this test?

  • 1: It was the first time
  • 2: More than once a year
  • 3: Between once a year to less than every 3 years
  • 4: Every 3 years
  • 5: Less often than every 3 years
  • 6: No fixed frequency
  • 8: RF
  • 9: DK

Mammography (MAM)

Mammography (MAM) - Question identifier:MAM_Q005

Have you ever had a mammogram, that is, a breast x-ray?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Mammography (MAM) - Question identifier:MAM_Q010

When was the last time?

  • 1: Less than 1 year to 1 year ago
  • 2: More than 1 year to 2 years ago
  • 3: More than 2 years to 3 years ago
  • 4: More than 3 years to 5 years ago
  • 5: More than 5 years ago
  • 8: RF
  • 9: DK

Mammography (MAM) - Question identifier:MAM_Q015

What were the reasons for having this mammogram?

  • 01: Family history of breast cancer
  • 02: Part of regular check-up / routine screening
  • 03: Age
  • 04: Previously detected lump
  • 05: Follow-up of breast cancer treatment
  • 06: On hormone replacement therapy
  • 07: Breast problem
  • 08: Other
  • 98: RF
  • 99: DK

Mammography (MAM) - Question identifier:MAM_Q020

What are the reasons you have not had a mammogram [in the past 3 years]?

  • 1: Lack of time
  • 2: Respondent did not think it was necessary
  • 3: Doctor did not think it was necessary/ he never brought it up
  • 4: Feelings of fear or discomfort
  • 5: Don't have a doctor
  • 6: Had a bilateral mastectomy (both breasts were removed)
  • 7: Other
  • 8: RF
  • 9: DK

Mammography (MAM) - Question identifier:MAM_Q025

How often do you usually have this test?

  • 1: It was the first time
  • 2: More than once a year
  • 3: Between once a year to less than every 3 years
  • 4: Every 3 years
  • 5: Less often than every 3 years
  • 6: No fixed frequency
  • 8: RF
  • 9: DK

Prostate cancer screening (PSA)

Prostate cancer screening (PSA) - Question identifier:PSA_R001

Now, a few questions related to prostate exams.

Prostate cancer screening (PSA) - Question identifier:PSA_Q005

Have you ever had a prostate specific antigen test for prostate cancer, that is, a PSA blood test?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Prostate cancer screening (PSA) - Question identifier:PSA_Q010

When was the last time?

  • 1: Less than 1 year to 1 year ago
  • 2: More than 1 year to 2 years ago
  • 3: More than 2 years to 3 years ago
  • 4: More than 3 years to 5 years ago
  • 5: More than 5 years ago
  • 8: RF
  • 9: DK

Prostate cancer screening (PSA) - Question identifier:PSA_Q015

Why did you have it?

  • 1: Family history of prostate cancer
  • 2: Part of regular check-up / routine screening
  • 3: Age
  • 4: Race
  • 5: Follow-up of problem
  • 6: Follow-up of prostate cancer treatment
  • 7: Other
  • 8: RF
  • 9: DK

Prostate cancer screening (PSA) - Question identifier:PSA_Q020

A Digital Rectal Exam is an exam in which a gloved finger is inserted into the rectum in order to feel the prostate gland.
Have you ever had this exam?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Prostate cancer screening (PSA) - Question identifier:PSA_Q025

When was the last time?

  • 1: Less than 1 year to 1 year ago
  • 2: More than 1 year to 2 years ago
  • 3: More than 2 years to 3 years ago
  • 4: More than 3 years to 5 years ago
  • 5: More than 5 years ago
  • 8: RF
  • 9: DK

Colorectal cancer testing (CCT)

Colorectal cancer testing (CCT) - Question identifier:CCT_R001

Now a few questions about colorectal tests.

Colorectal cancer testing (CCT) - Question identifier:CCT_Q005

A fecal test is a test to check for blood in the stool, in which a stick is used to smear a small stool sample on a special card.

Have you ever had this test?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Colorectal cancer testing (CCT) - Question identifier:CCT_Q010

When was the last time?

  • 1: 6 months ago or less
  • 2: More than 6 months to 1 year ago
  • 3: More than 1 year to 2 years ago
  • 4: More than 2 years to 5 years ago
  • 5: More than 5 years ago
  • 8: RF
  • 9: DK

Colorectal cancer testing (CCT) - Question identifier:CCT_Q015

What are the reasons you did not have a fecal test [in the past 2 years]?

  • 01: Lack of time
  • 02: No access to test (distance, clinic hours or cost)
  • 03: Respondent did not think it was necessary
  • 04: Doctor did not think it was necessary/ he never brought it up
  • 05: Feelings of fear or discomfort
  • 06: Don't have a doctor
  • 07: Had a colonoscopy or sigmoidoscopy instead
  • 08: Did not know it existed/it was a possibility
  • 09: Other
  • 98: RF
  • 99: DK

Colorectal cancer testing (CCT) - Question identifier:CCT_Q020

How often do you usually have this test?

  • 1: It was the first time
  • 2: More than once a year
  • 3: Every year
  • 4: Every 2 years
  • 5: Less than once every 2 years
  • 6: No fixed frequency
  • 8: RF
  • 9: DK

Colorectal cancer testing (CCT) - Question identifier:CCT_R025

A sigmoidoscopy and a colonoscopy are two tests in which a tube is inserted into the rectum in order to detect signs of cancer or other health problems.

A colonoscopy examines the entire colon, while a sigmoidoscopy only examines the first section of the colon. The sigmoidoscopy requires less preparation.

Colorectal cancer testing (CCT) - Question identifier:CCT_Q025

Have you ever had either one of these tests?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Colorectal cancer testing (CCT) - Question identifier:CCT_Q030

What are the reasons you have not had these tests?

  • 01: Lack of time
  • 02: No access to test (distance, clinic hours or cost)
  • 03: Respondent did not think it was necessary
  • 04: Doctor did not think it was necessary/ he never brought it up
  • 05: Feelings of fear or discomfort
  • 06: Don't have a doctor
  • 07: Had a fecal test instead
  • 08: Did not know it existed/it was a possibility
  • 09: Other
  • 98: RF
  • 99: DK

Colorectal cancer testing (CCT) - Question identifier:CCT_Q035

Which of these tests have you had[, a colonoscopy, a sigmoidoscopy or both]?

  • 1: Colonoscopy
  • 2: Sigmoidoscopy
  • 3: Both
  • 8: RF
  • 9: DK

Colorectal cancer testing (CCT) - Question identifier:CCT_Q040

When was the last time you had a sigmoidoscopy?

  • 1: 1 year ago or less
  • 2: More than 1 year to 2 years ago
  • 3: More than 2 years to 5 years ago
  • 4: More than 5 years to 10 years ago
  • 5: More than 10 years ago
  • 8: RF
  • 9: DK

Colorectal cancer testing (CCT) - Question identifier:CCT_Q045

What are the reasons you have not had this test in the past 10 years?

  • 01: Lack of time
  • 02: No access to test (distance, clinic hours or cost)
  • 03: Respondent did not think it was necessary
  • 04: Doctor did not think it was necessary/ he never brought it up
  • 05: Feelings of fear or discomfort
  • 06: Don't have a doctor
  • 07: Had a different colorectal test instead
  • 08: Did not know it existed/it was a possibility
  • 09: Other
  • 98: RF
  • 99: DK

Colorectal cancer testing (CCT) - Question identifier:CCT_Q050

How often do you usually have this test?

  • 1: It was the first time
  • 2: More than once every 5 years
  • 3: Every 5 years
  • 4: Less than once every 5 years
  • 5: No fixed frequency
  • 8: RF
  • 9: DK

Colorectal cancer testing (CCT) - Question identifier:CCT_Q055

When was the last time you had a colonoscopy?

  • 1: 1 year ago or less
  • 2: More than 1 year to 2 years ago
  • 3: More than 2 years to 5 years ago
  • 4: More than 5 years to 10 years ago
  • 5: More than 10 years ago
  • 8: RF
  • 9: DK

Colorectal cancer testing (CCT) - Question identifier:CCT_Q065

What are the reasons you have not had this test in the past 10 years?

  • 01: Lack of time
  • 02: No access to test (distance, clinic hours or cost)
  • 03: Respondent did not think it was necessary
  • 04: Doctor did not think it was necessary/ he never brought it up
  • 05: Feelings of fear or discomfort
  • 06: Don't have a doctor
  • 07: Had a different colorectal test instead
  • 08: Did not know it existed/it was a possibility
  • 09: Other
  • 98: RF
  • 99: DK

Colorectal cancer testing (CCT) - Question identifier:CCT_Q070

How often do you usually have this test?

  • 1: It was the first time
  • 2: More than once every 10 years
  • 3: Every 10 years
  • 4: Less than once every 10 years
  • 5: No fixed frequency
  • 8: RF
  • 9: DK

Colorectal cancer testing (CCT) - Question identifier:CCT_Q075

Was the colonoscopy or sigmoidoscopy a follow-up of the results of a fecal test?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Colorectal cancer testing (CCT) - Question identifier:CCT_Q080

Were you prescribed [a colonoscopy / a sigmoidoscopy / one of these tests] because of a family history, an inflammatory bowel disease, a colorectal cancer follow-up or other symptoms?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Spirometry (SPI)

Spirometry (SPI) - Question identifier:SPI_Q005

Spirometry is a common lung function test that consists of blowing into a small tube attached to a machine.

Have you ever had this test?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Spirometry (SPI) - Question identifier:SPI_Q010

When was the last time?

  • 1: Less than 6 months ago
  • 2: 6 months to less than 1 year ago
  • 3: 1 year to less than 2 years ago
  • 4: 2 years to less than 5 years ago
  • 5: 5 or more years ago
  • 8: RF
  • 9: DK

Diabetes care (DIA)

Diabetes care (DIA) - Question identifier:DIA_R001

You reported earlier that you have diabetes. The following questions are about diabetes care.

Diabetes care (DIA) - Question identifier:DIA_Q005

In the past 12 months, has a health care professional tested you for haemoglobin "A-one-C"? (An "A-one-C" haemoglobin test measures the average level of blood sugar over a 3-month period.)

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Diabetes care (DIA) - Question identifier:DIA_Q010

How many times? (In the past 12 months, has a health care professional tested you for haemoglobin "A-one-C"?)

Min = 1; Max = 99

Diabetes care (DIA) - Question identifier:DIA_Q015

In the past 12 months, has a health care professional checked your feet for any sores or irritations?

  • 1: Yes
  • 2: No
  • 3: No feet
  • 8: RF
  • 9: DK

Diabetes care (DIA) - Question identifier:DIA_Q020

How many times? (In the past 12 months, has a health care professional checked your feet for any sores or irritations?)

Min = 1; Max = 99

Diabetes care (DIA) - Question identifier:DIA_Q025

In the past 12 months, has a health care professional tested your urine for protein (i.e., Microalbumin)?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Diabetes care (DIA) - Question identifier:DIA_Q030

Have you ever had an eye exam where the pupils of your eyes were dilated? (This procedure would have made you temporarily sensitive to light.)

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Diabetes care (DIA) - Question identifier:DIA_Q035

When was the last time?

  • 1: Less than 1 year ago
  • 2: 1 year to less than 2 years ago
  • 3: 2 or more years ago
  • 8: RF
  • 9: DK

Diabetes care (DIA) - Question identifier:DIA_Q040

In the past 12 months, has a dietitian provided you with nutrition therapy adapted for people with diabetes? Please exclude advice received by a nurse.

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Diabetes care (DIA) - Question identifier:DIA_R045

Now, some questions about diabetes care not provided by a health care professional.

Diabetes care (DIA) - Question identifier:DIA_Q045

How often do you usually have your blood checked for glucose or sugar by yourself or by a family member or friend?

Min = 0; Max = 365

Diabetes care (DIA) - Question identifier:DIA_N045A

Select the reporting period.

  • 1: Per day
  • 2: Per week
  • 3: Per month
  • 4: Per year

Diabetes care (DIA) - Question identifier:DIA_Q050

How often do you usually have your feet checked for any sores or irritations by yourself or by a family member or friend?

Min = 0; Max = 365

Diabetes care (DIA) - Question identifier:DIA_N050A

Select the reporting period.

  • 1: Per day
  • 2: Per week
  • 3: Per month
  • 4: Per year

Diabetes care (DIA) - Question identifier:DIA_R055

Now, a few questions about medication.

Diabetes care (DIA) - Question identifier:DIA_Q055

In the past month, have you taken any medicine for high blood pressure?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Diabetes care (DIA) - Question identifier:DIA_Q060

In the past month, have you taken any medicine for high blood cholesterol or lipids?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Consultations about mental health (CMH)

Consultations about mental health (CMH) - Question identifier:CMH_R001

Now I would like to ask you some questions about mental and emotional well-being.

Consultations about mental health (CMH) - Question identifier:CMH_Q005

In the past 12 months, that is, from [date one year ago] to yesterday, have you seen or talked to a health professional about your emotional or mental health?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Consultations about mental health (CMH) - Question identifier:CMH_Q010

How many times (in the past 12 months)?

Min = 1; Max = 366

Consultations about mental health (CMH) - Question identifier:CMH_Q015

Whom did you see or talk to?

  • 1: Family doctor or general practitioner
  • 2: Psychiatrist
  • 3: Psychologist
  • 4: Nurse
  • 5: Social worker or counsellor
  • 6: Other - Specify
  • 8: RF
  • 9: DK

Satisfaction with life (SWL)

Satisfaction with life (SWL) - Question identifier:SWL_R001

Now, I'd like to ask about your satisfaction with various aspects of your life. For each question, please tell me whether you are very satisfied, satisfied, neither satisfied nor dissatisfied, dissatisfied or very dissatisfied.

Satisfaction with life (SWL) - Question identifier:SWL_Q005

How satisfied are you with your job or main activity?

  • 1: Very satisfied
  • 2: Satisfied
  • 3: Neither satisfied nor dissatisfied
  • 4: Dissatisfied
  • 5: Very dissatisfied
  • 8: RF
  • 9: DK

Satisfaction with life (SWL) - Question identifier:SWL_Q010

How satisfied are you with your leisure activities?

  • 1: Very satisfied
  • 2: Satisfied
  • 3: Neither satisfied nor dissatisfied
  • 4: Dissatisfied
  • 5: Very dissatisfied
  • 8: RF
  • 9: DK

Satisfaction with life (SWL) - Question identifier:SWL_Q015

How satisfied are you with your financial situation?

  • 1: Very satisfied
  • 2: Satisfied
  • 3: Neither satisfied nor dissatisfied
  • 4: Dissatisfied
  • 5: Very dissatisfied
  • 8: RF
  • 9: DK

Satisfaction with life (SWL) - Question identifier:SWL_Q020

How satisfied are you with yourself?

  • 1: Very satisfied
  • 2: Satisfied
  • 3: Neither satisfied nor dissatisfied
  • 4: Dissatisfied
  • 5: Very dissatisfied
  • 8: RF
  • 9: DK

Satisfaction with life (SWL) - Question identifier:SWL_Q025

How satisfied are you with the way your body looks?

  • 1: Very satisfied
  • 2: Satisfied
  • 3: Neither satisfied nor dissatisfied
  • 4: Dissatisfied
  • 5: Very dissatisfied
  • 8: RF
  • 9: DK

Satisfaction with life (SWL) - Question identifier:SWL_Q030

How satisfied are you with your relationships with family members?

  • 1: Very satisfied
  • 2: Satisfied
  • 3: Neither satisfied nor dissatisfied
  • 4: Dissatisfied
  • 5: Very dissatisfied
  • 8: RF
  • 9: DK

Satisfaction with life (SWL) - Question identifier:SWL_Q035

How satisfied are you with your relationships with friends?

  • 1: Very satisfied
  • 2: Satisfied
  • 3: Neither satisfied nor dissatisfied
  • 4: Dissatisfied
  • 5: Very dissatisfied
  • 8: RF
  • 9: DK

Satisfaction with life (SWL) - Question identifier:SWL_Q040

How satisfied are you with your housing?

  • 1: Very satisfied
  • 2: Satisfied
  • 3: Neither satisfied nor dissatisfied
  • 4: Dissatisfied
  • 5: Very dissatisfied
  • 8: RF
  • 9: DK

Satisfaction with life (SWL) - Question identifier:SWL_Q045

How satisfied are you with your neighbourhood?

  • 1: Very satisfied
  • 2: Satisfied
  • 3: Neither satisfied nor dissatisfied
  • 4: Dissatisfied
  • 5: Very dissatisfied
  • 8: RF
  • 9: DK

Depression (DEP)

Depression (DEP) - Question identifier:DEP_R001

The following questions deal with problems you may have had during the last two weeks.

Depression (DEP) - Question identifier:DEP_Q005

Over the last two weeks, how often have you:

had little interest or pleasure in doing things?

  • 1: Not at all
  • 2: Several days
  • 3: More than half the days
  • 4: Nearly every day
  • 8: RF
  • 9: DK

Depression (DEP) - Question identifier:DEP_Q010

Over the last two weeks, how often have you:

felt down, depressed, or hopeless?

  • 1: Not at all
  • 2: Several days
  • 3: More than half the days
  • 4: Nearly every day
  • 8: RF
  • 9: DK

Depression (DEP) - Question identifier:DEP_Q015

Over the last two weeks, how often have you:

had trouble falling or staying asleep, or sleeping too much?

  • 1: Not at all
  • 2: Several days
  • 3: More than half the days
  • 4: Nearly every day
  • 8: RF
  • 9: DK

Depression (DEP) - Question identifier:DEP_Q020

Over the last two weeks, how often have you:

felt tired or had little energy?

  • 1: Not at all
  • 2: Several days
  • 3: More than half the days
  • 4: Nearly every day
  • 8: RF
  • 9: DK

Depression (DEP) - Question identifier:DEP_Q025

Over the last two weeks, how often have you:

had poor appetite or overate?

  • 1: Not at all
  • 2: Several days
  • 3: More than half the days
  • 4: Nearly every day
  • 8: RF
  • 9: DK

Depression (DEP) - Question identifier:DEP_Q030

Over the last two weeks, how often have you:

felt bad about yourself, or that you are a failure or have let yourself or your family down?

  • 1: Not at all
  • 2: Several days
  • 3: More than half the days
  • 4: Nearly every day
  • 8: RF
  • 9: DK

Depression (DEP) - Question identifier:DEP_Q035

Over the last two weeks, how often have you:

had trouble concentrating on things, such as reading the newspaper or watching television?

  • 1: Not at all
  • 2: Several days
  • 3: More than half the days
  • 4: Nearly every day
  • 8: RF
  • 9: DK

Depression (DEP) - Question identifier:DEP_Q040

Over the last two weeks, how often have you:

been moving or speaking so slowly that other people could have noticed? Or the opposite, being so fidgety or restless that you have been moving around a lot more than usual?

  • 1: Not at all
  • 2: Several days
  • 3: More than half the days
  • 4: Nearly every day
  • 8: RF
  • 9: DK

Depression (DEP) - Question identifier:DEP_Q045

Over the last two weeks, how often have you:

had thoughts that you would be better off dead, or of hurting yourself?

  • 1: Not at all
  • 2: Several days
  • 3: More than half the days
  • 4: Nearly every day
  • 8: RF
  • 9: DK

Depression (DEP) - Question identifier:DEP_Q050

How difficult have these problems made it for you to do your work, take care of things at home, or get along with other people?

  • 1: Not difficult at all
  • 2: Somewhat difficult
  • 3: Very difficult
  • 4: Extremely difficult
  • 8: RF
  • 9: DK

Suicidal thoughts and attempts (SUI)

Suicidal thoughts and attempts (SUI) - Question identifier:SUI_R001

The following questions may be sensitive to some people, but we have to ask the same questions of everyone.

Suicidal thoughts and attempts (SUI) - Question identifier:SUI_Q005

Have you ever seriously contemplated suicide?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Suicidal thoughts and attempts (SUI) - Question identifier:SUI_Q010

Has this happened in the past 12 months?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Suicidal thoughts and attempts (SUI) - Question identifier:SUI_Q015

How old were you the last time this experience happened?

Min = 6; Max = 129

Suicidal thoughts and attempts (SUI) - Question identifier:SUI_Q020

Have you ever made a plan to seriously attempt suicide?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Suicidal thoughts and attempts (SUI) - Question identifier:SUI_Q025

Has this happened in the past 12 months?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Suicidal thoughts and attempts (SUI) - Question identifier:SUI_Q030

How old were you the last time this experience happened?

Min = 6; Max = 129

Suicidal thoughts and attempts (SUI) - Question identifier:SUI_Q035

Have you ever seriously attempted suicide?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Suicidal thoughts and attempts (SUI) - Question identifier:SUI_Q040

How many times did you seriously attempt suicide in your lifetime?

Min = 1; Max = 901

Suicidal thoughts and attempts (SUI) - Question identifier:SUI_Q045

Did this happen in the past 12 months?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Suicidal thoughts and attempts (SUI) - Question identifier:SUI_Q050

How old were you [when/the last time] this experience happened?

Min = 6; Max = 129

Suicidal thoughts and attempts (SUI) - Question identifier:SUI_Q055

Following your most recent experience, did you require medical attention?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Sources of stress (STS)

Sources of stress (STS) - Question identifier:STS_R001

Now a few questions about the stress in your life.

Sources of stress (STS) - Question identifier:STS_Q005

In general, how would you rate your ability to handle unexpected and difficult problems, for example, a family or personal crisis? Would you say your ability is...?

  • 1: Excellent
  • 2: Good
  • 3: Fair
  • 4: Poor
  • 8: RF
  • 9: DK

Sources of stress (STS) - Question identifier:STS_Q010

In general, how would you rate your ability to handle the day-to-day demands in your life, for example, handling work, family and volunteer responsibilities? Would you say your ability is...?

  • 1: Excellent
  • 2: Good
  • 3: Fair
  • 4: Poor
  • 8: RF
  • 9: DK

Sources of stress (STS) - Question identifier:STS_Q015

Thinking about stress in your day-to-day life, what would you say is the most important thing contributing to feelings of stress you may have?

  • 01: Work
  • 02: Financial concerns
  • 03: Family
  • 04: School work
  • 05: Time pressures / not enough time
  • 06: Health
  • 07: Other - Specify
  • 08: None
  • 98: RF
  • 99: DK

Childhood experiences (CEX)

Childhood experiences (CEX) - Question identifier:CEX_R001

The next few questions are about things that may have happened to you before you were 16 in your school, in your neighbourhood, or in your family. Your responses are important whether or not you have had any of these experiences. Remember that all information provided is strictly confidential.

Childhood experiences (CEX) - Question identifier:CEX_Q005

Before age 16, how many times did you see or hear any one of your parents, step-parents or guardians hit each other or another adult in your home? By adult, I mean anyone 18 years and over.

  • 1: Never
  • 2: 1 or 2 times
  • 3: 3 to 5 times
  • 4: 6 to 10 times
  • 5: More than 10 times
  • 8: RF
  • 9: DK

Childhood experiences (CEX) - Question identifier:CEX_Q010

Before age 16, how many times did an adult slap you on the face, head or ears or hit or spank you with something hard to hurt you?

  • 1: Never
  • 2: 1 or 2 times
  • 3: 3 to 5 times
  • 4: 6 to 10 times
  • 5: More than 10 times
  • 8: RF
  • 9: DK

Childhood experiences (CEX) - Question identifier:CEX_Q015

Before age 16, how many times did an adult push, grab, shove or throw something at you to hurt you?

  • 1: Never
  • 2: 1 or 2 times
  • 3: 3 to 5 times
  • 4: 6 to 10 times
  • 5: More than 10 times
  • 8: RF
  • 9: DK

Childhood experiences (CEX) - Question identifier:CEX_Q020

Before age 16, how many times did an adult kick, bite, punch, choke, burn you or physically attack you in some way?

  • 1: Never
  • 2: 1 or 2 times
  • 3: 3 to 5 times
  • 4: 6 to 10 times
  • 5: More than 10 times
  • 8: RF
  • 9: DK

Childhood experiences (CEX) - Question identifier:CEX_Q025

Before age 16, how many times did an adult force you, or attempt to force you into any unwanted sexual activity, by threatening you, holding you down or hurting you in some way?

  • 1: Never
  • 2: 1 or 2 times
  • 3: 3 to 5 times
  • 4: 6 to 10 times
  • 5: More than 10 times
  • 8: RF
  • 9: DK

Childhood experiences (CEX) - Question identifier:CEX_Q030

Before age 16, how many times did an adult touch you against your will in any sexual way? By this, I mean anything from unwanted touching or grabbing, to kissing or fondling.

  • 1: Never
  • 2: 1 or 2 times
  • 3: 3 to 5 times
  • 4: 6 to 10 times
  • 5: More than 10 times
  • 8: RF
  • 9: DK

Childhood experiences (CEX) - Question identifier:CEX_Q035

Before age 16, did you ever see or talk to anyone from a child protection organization about difficulties at home?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Social provisions (SPS)

Social provisions (SPS) - Question identifier:SPS_R001

The next questions are about your current relationships with friends, family members, co-workers, community members, and so on. Please indicate to what extent each statement describes your current relationships with other people.

Social provisions (SPS) - Question identifier:SPS_Q015

I have close relationships that provide me with a sense of emotional security and wellbeing.

  • 1: Strongly agree
  • 2: Agree
  • 3: Disagree
  • 4: Strongly disagree
  • 8: RF
  • 9: DK

Social provisions (SPS) - Question identifier:SPS_Q020

There is someone I could talk to about important decisions in my life.

  • 1: Strongly agree
  • 2: Agree
  • 3: Disagree
  • 4: Strongly disagree
  • 8: RF
  • 9: DK

Social provisions (SPS) - Question identifier:SPS_Q025

I have relationships where my competence and skill are recognized.

  • 1: Strongly agree
  • 2: Agree
  • 3: Disagree
  • 4: Strongly disagree
  • 8: RF
  • 9: DK

Social provisions (SPS) - Question identifier:SPS_Q035

I feel part of a group of people who share my attitudes and beliefs.

  • 1: Strongly agree
  • 2: Agree
  • 3: Disagree
  • 4: Strongly disagree
  • 8: RF
  • 9: DK

Social provisions (SPS) - Question identifier:SPS_Q050

There are people I can count on in an emergency.

  • 1: Strongly agree
  • 2: Agree
  • 3: Disagree
  • 4: Strongly disagree
  • 8: RF
  • 9: DK

Primary health care (PHC)

Primary health care (PHC) - Question identifier:PHC_R001

Now I'd like to ask about your primary health care. It is often the first point of entry to the Canadian health system. It incorporates diagnosis, treatment and management of health problems.

Primary health care (PHC) - Question identifier:PHC_Q005

Is there a place that you usually go to when you need immediate care for a minor health problem?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Primary health care (PHC) - Question identifier:PHC_Q010

What kind of place is it?

  • 1: A doctor's office
  • 2: A hospital outpatient clinic
  • 3: A community health centre [or CLSC]
  • 4: A walk-in clinic
  • 5: A hospital emergency room
  • 6: Some other place
  • 8: RF
  • 9: DK

Primary health care (PHC) - Question identifier:PHC_Q015

Is this...?

  • 1: An office with one doctor working in a solo practice
  • 2: An office with several health care professionals working together as a team, that may include a dietician, nurse, social worker or psychologist
  • 3: An office with several doctors working independently of each other, who may share one or more nurses
  • 4: Other
  • 8: RF
  • 9: DK

Primary health care (PHC) - Question identifier:PHC_Q020

Do you have have a regular health care provider? By this, we mean one health professional that you regularly see or talk to when you need care or advice for your health.

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Primary health care (PHC) - Question identifier:PHC_Q025

What are the reasons why you do not have a regular health care provider?

  • 1: Do not need one in particular, but you have a usual place of care
  • 2: No one available in the area
  • 3: No one in the area is taking new patients
  • 4: [You] have not tried to find one
  • 5: Had one who left or retired
  • 6: Other
  • 8: RF
  • 9: DK

Primary health care (PHC) - Question identifier:PHC_Q030

Is that regular health care provider a...?

  • 1: Family doctor or general practitioner
  • 2: Medical specialist such as a cardiologist or a pediatrician
  • 3: Nurse practitioner
  • 4: Other
  • 8: RF
  • 9: DK

Primary health care (PHC) - Question identifier:PHC_Q035

When you need immediate care for a minor health problem, how long do you usually have to wait before you can have an appointment with this [family physician / specialist / nurse practitioner / regular health care provider] [or another care provider from the same office?]

  • 1: On the same day
  • 2: The next day
  • 3: In 2 to 3 days
  • 4: In 4 to 6 days
  • 5: In 1 to 2 weeks
  • 6: Between 2 weeks and one month
  • 7: One month or more
  • 8: RF
  • 9: DK

Primary health care (PHC) - Question identifier:PHC_Q040

Do you usually speak in English, in French or in another language with this [family physician / specialist / nurse practitioner / regular health care provider?]

  • 1: English
  • 2: French
  • 3: English and French
  • 4: English and another language
  • 5: French and another language
  • 6: Another language
  • 8: RF
  • 9: DK

Primary health care (PHC) - Question identifier:PHC_Q045

Is there one or more nurses working with your [family physician / specialist / nurse practitioner / regular health care provider] who are regularly involved in your health care?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Primary health care (PHC) - Question identifier:PHC_Q050

Other than doctors and nurses, are there other health professionals like nutritionists working in the same office where you get your regular health care?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Primary health care (PHC) - Question identifier:PHC_Q055

Other than from your [family physician / specialist / nurse practitioner / regular health care provider], who do you receive regular health care from?

  • 01: Another family doctor or general practitioner
  • 02: Specialist doctor
  • 03: Nurse / Nurse practitioner
  • 04: Chiropractor
  • 05: Registered dietician
  • 06: Pharmacist
  • 07: Physiotherapist
  • 08: Psychologist / Mental Health Professional
  • 09: Social Worker
  • 10: Other
  • 11: None
  • 98: RF
  • 99: DK

Primary health care (PHC) - Question identifier:PHC_Q060

In general, how would you rate the level of coordination between your [family physician / specialist / nurse practitioner / regular health care provider] and other health professionals who provide you with regular care? Would you say the coordination is...?

  • 1: Excellent
  • 2: Very good
  • 3: Good
  • 4: Fair
  • 5: Poor
  • 6: Not applicable
  • 8: RF
  • 9: DK

Medical doctor attachment (MDA)

Medical doctor attachment (MDA) - Question identifier:MDA_Q005

How long have you had your family doctor or general practitioner for?

  • 1: Less than 6 months
  • 2: 6 months to less than 1 year
  • 3: 1 year to less than 2 years
  • 4: 2 years or more
  • 8: RF
  • 9: DK

Medical doctor attachment (MDA) - Question identifier:MDA_Q010

Are you currently looking for a family doctor or general practitioner?

  • 1: Yes
  • 2: No
  • 3: Not applicable; [I already have one]
  • 8: RF
  • 9: DK

Medical doctor attachment (MDA) - Question identifier:MDA_Q015

Earlier you said that you have a usual place to go when you need care for a minor health problem. In this place, is there more than one medical doctor who you can see?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Medical doctor attachment (MDA) - Question identifier:MDA_Q020

When you go to that usual place, how often are you taken care of by the same medical doctor?

  • 1: Always
  • 2: Often
  • 3: Sometimes
  • 4: Rarely
  • 5: Never
  • 6: Not applicable
  • 8: RF
  • 9: DK

Contacts with health professionals - extended block (CP2)

Contacts with health professionals - extended block (CP2) - Question identifier:CP2_Q005

[Not counting when you were an overnight patient,] in the past 12 months, have you seen or talked to any of the following health professionals about your physical, emotional or mental health:

a chiropractor?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Contacts with health professionals - extended block (CP2) - Question identifier:CP2_Q010

How many times (in the past 12 months)?

Min = 1; Max = 366

Contacts with health professionals - extended block (CP2) - Question identifier:CP2_Q015

[Not counting when you were an overnight patient,] in the past 12 months, have you seen or talked to

a physiotherapist?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Contacts with health professionals - extended block (CP2) - Question identifier:CP2_Q020

How many times (in the past 12 months)?

Min = 1; Max = 366

Contacts with health professionals - extended block (CP2) - Question identifier:CP2_Q025

[Not counting when you were an overnight patient,] in the past 12 months, have you seen or talked to

a psychologist (about your physical, emotional or mental health)?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Contacts with health professionals - extended block (CP2) - Question identifier:CP2_Q030

How many times (in the past 12 months)?

Min = 1; Max = 366

Contacts with health professionals - extended block (CP2) - Question identifier:CP2_Q035

[Not counting when you were an overnight patient,] in the past 12 months, have you seen or talked to:

a social worker or counsellor?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Contacts with health professionals - extended block (CP2) - Question identifier:CP2_Q040

How many times (in the past 12 months)?

Min = 1; Max = 366

Contacts with health professionals - extended block (CP2) - Question identifier:CP2_Q045

[Not counting when you were an overnight patient,] in the past 12 months, have you seen or talked to

an audiologist, a speech or occupational therapist?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Contacts with health professionals - extended block (CP2) - Question identifier:CP2_Q050

How many times (in the past 12 months)?

Min = 1; Max = 200

Contacts with health professionals - extended block (CP2) - Question identifier:CP2_Q055

[Not counting when you were an overnight patient,] in the past 12 months, have you seen or talked to

a dietician or nutritionist?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Contacts with health professionals - extended block (CP2) - Question identifier:CP2_Q060

How many times (in the past 12 months)?

Min = 1; Max = 366

Contacts with health professionals - extended block (CP2) - Question identifier:CP2_Q065

[Not counting when you were an overnight patient,] in the past 12 months, have you consulted with or sought advice from a pharmacist?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Contacts with health professionals - extended block (CP2) - Question identifier:CP2_Q070

How many times (in the past 12 months)?

Min = 1; Max = 366

Contacts with dental professionals (CP3)

Contacts with dental professionals (CP3) - Question identifier:CP3_R001

Now I'd like to ask about your contacts with dental health professionals during the past 12 months, that is, from [date one year ago] to yesterday.

Contacts with dental professionals (CP3) - Question identifier:CP3_Q005

In the past 12 months, have you seen or talked to a dental professional, such as a dentist, a dental hygienist or a denturologist?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Contacts with dental professionals (CP3) - Question identifier:CP3_Q010

How many times (in the past 12 months)?

Min = 1; Max = 99

Perceived need for care (PNC)

Perceived need for care (PNC) - Question identifier:PNC_R01

The following questions deal with the different kinds of help you received, or thought you needed, for problems with your emotions, mental health or use of alcohol or drugs.

Perceived need for care (PNC) - Question identifier:PNC_Q01

During the past 12 months, did you receive the following kinds of help because of problems with your emotions, mental health or use of alcohol or drugs?

  • 1: Information about these problems, treatments or available services
  • 2: Medication
  • 3: Counselling, therapy, or help for problems with personal relationships
  • 4: Other type of help
  • 5: None
  • 8: RF
  • 9: DK

Perceived need for care (PNC) - Question identifier:PNC_Q02A

You mentioned that you received:

[information about these problems, treatments or available services / medication / counselling, therapy, or help for problems with personal relationships / other help].

Do you think you got as much of [each of these kinds / this kind] of help as you needed (during the past 12 months)?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Perceived need for care (PNC) - Question identifier:PNC_Q02B

Which kind of help did you need more of (during the past 12 months)?

  • 1: Information about these problems, treatments or available services
  • 2: Medication
  • 3: Counselling, therapy, or help for problems with personal relationships
  • 4: Other
  • 8: RF
  • 9: DK

Perceived need for care (PNC) - Question identifier:PNC_Q03A

Why didn't you get [more information about these problems, treatments or available services / more medication / more counselling, therapy, or help for problems with personal relationships / more of the other kind of help you mentioned] (during the past 12 months)?

  • 01: You preferred to manage yourself
  • 02: You didn't know how or where to get this kind of help
  • 03: You haven't gotten around to it (e.g., too busy)
  • 04: Your job interfered (e.g., workload, hours of work or no cooperation from supervisor)
  • 05: Help was not readily available
  • 06: You didn't have confidence in health care system or social services
  • 07: You couldn't afford to pay
  • 08: Insurance did not cover
  • 09: You were afraid of what others would think of you
  • 10: Language problems
  • 11: Help is ongoing
  • 12: Other
  • 98: RF
  • 99: DK

Perceived need for care (PNC) - Question identifier:PNC_Q03B

Which of the following best describes why you preferred to manage yourself rather than seek help (during the past 12 months)?

  • 01: You didn't think they knew how to help
  • 02: You were uncomfortable talking about these problems
  • 03: You relied on faith and spirituality
  • 04: You relied on family and friends
  • 05: You felt you'd be treated differently if people thought you had these problems
  • 06: You didn't feel ready to seek help
  • 07: You couldn't get this kind of help where you live
  • 08: Other
  • 98: RF
  • 99: DK

Perceived need for care (PNC) - Question identifier:PNC_Q04A

You mentioned that you did not receive:

[Information about these problems, treatments or available services / medication / counselling, therapy, or help for problems with personal relationships / other help].

Do you think you needed [this kind / any of these kinds] of help (during the past 12 months)?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Perceived need for care (PNC) - Question identifier:PNC_Q04B

Which kind of help did you need (during the past 12 months)?

  • 1: Information about these problems, treatments or available services
  • 2: Medication
  • 3: Counselling, therapy, or help for problems with personal relationships
  • 8: RF
  • 9: DK

Perceived need for care (PNC) - Question identifier:PNC_Q05A

Why didn't you get [more information about these problems, treatments or available services / more medication / more counselling, therapy, or help for problems with personal relationships / more of the other kind of help you mentioned] (during the past 12 months)?

  • 01: You preferred to manage yourself
  • 02: You didn't know how or where to get this kind of help
  • 03: You haven't gotten around to it (e.g., too busy)
  • 04: Your job interfered (e.g., workload, hours of work or no cooperation from supervisor)
  • 05: Help was not readily available
  • 06: You didn't have confidence in health care system or social services
  • 07: You couldn't afford to pay
  • 08: Insurance did not cover
  • 09: You were afraid of what others would think of you
  • 10: Language problems
  • 11: Help is ongoing
  • 12: Other
  • 98: RF
  • 99: DK

Perceived need for care (PNC) - Question identifier:PNC_Q05B

Which of the following best describes why you preferred to manage yourself rather than seek help (during the past 12 months)?

  • 01: You didn't think they knew how to help
  • 02: You were uncomfortable talking about these problems
  • 03: You relied on faith and spirituality
  • 04: You relied on family and friends
  • 05: You felt you'd be treated differently if people thought you had these problems
  • 06: You didn't feel ready to seek help
  • 07: You couldn't get this kind of help where you live
  • 08: Other
  • 98: RF
  • 99: DK

Patient satisfaction - community-based care (PSC)

Patient satisfaction - community-based care (PSC) - Question identifier:PSC_R001

The next questions are about community-based health care which include other health care services received outside of a hospital or doctor's office.

Examples are: home nursing care, home-based counselling or therapy, personal care and community health clinics.

Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q005

In the past 12 months, have you received any community-based care?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q010

Overall, how would you rate the quality of the community-based care you received? Would you say it was...?

  • 1: Excellent
  • 2: Good
  • 3: Fair
  • 4: Poor
  • 8: RF
  • 9: DK

Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q015

Using a scale of 0 to 5, where 0 means "Very dissatisfied" and 5 means "Very satisfied", overall, how satisfied were you with the way community-based care was provided?

  • 0: Very dissatisfied
  • 1: |
  • 2: |
  • 3: |
  • 4: V
  • 5: Very satisfied
  • 8: RF
  • 9: DK

Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q020

In the past 12 months, have you received any home nursing care?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q025

Overall, how would you rate the quality of the home nursing care you received? Would you say it was...?

  • 1: Excellent
  • 2: Good
  • 3: Fair
  • 4: Poor
  • 8: RF
  • 9: DK

Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q030

Using a scale of 0 to 5, where 0 means "Very dissatisfied" and 5 means "Very satisfied", overall, how satisfied were you with the way the home nursing care was provided?

  • 0: Very dissatisfied
  • 1: |
  • 2: |
  • 3: |
  • 4: V
  • 5: Very satisfied
  • 8: RF
  • 9: DK

Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q035

In the past 12 months, have you received any home-based counselling or therapy?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q040

Overall, how would you rate the quality of the home-based counselling or therapy you received? Would you say it was...?

  • 1: Excellent
  • 2: Good
  • 3: Fair
  • 4: Poor
  • 8: RF
  • 9: DK

Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q045

Using a scale of 0 to 5, where 0 means "Very dissatisfied" and 5 means "Very satisfied", overall, how satisfied were you with the way the home-based counselling or therapy was provided?

  • 0: Very dissatisfied
  • 1: |
  • 2: |
  • 3: |
  • 4: V
  • 5: Very satisfied
  • 8: RF
  • 9: DK

Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q050

In the past 12 months, have you received any personal care services?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q055

Overall, how would you rate the quality of the personal care service you received? Would you say it was...?

  • 1: Excellent
  • 2: Good
  • 3: Fair
  • 4: Poor
  • 8: RF
  • 9: DK

Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q060

Using a scale of 0 to 5, where 0 means "Very dissatisfied" and 5 means "Very satisfied", overall, how satisfied were you with the way the personal care service was provided?

  • 0: Very dissatisfied
  • 1: |
  • 2: |
  • 3: |
  • 4: V
  • 5: Very satisfied
  • 8: RF
  • 9: DK

Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q065

In the past 12 months, have you received any services from a community walk-in clinic?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q070

Overall, how would you rate the quality of the service you received at the community walk-in clinic? Would you say it was...?

  • 1: Excellent
  • 2: Good
  • 3: Fair
  • 4: Poor
  • 8: RF
  • 9: DK

Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q075

Using a scale of 0 to 5, where 0 means "Very dissatisfied" and 5 means "Very satisfied", overall, how satisfied were you with the way the community walk-in clinic service was provided?

  • 0: Very dissatisfied
  • 1: |
  • 2: |
  • 3: |
  • 4: V
  • 5: Very satisfied
  • 8: RF
  • 9: DK

Consultations with health professionals on smoking (SPC)

Consultations with health professionals on smoking (SPC) - Question identifier:SPC_Q005

Does your [family physician/specialist/nurse practitioner/regular health care provider?] know that you [smoke / smoked] cigarettes?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Consultations with health professionals on smoking (SPC) - Question identifier:SPC_Q010

In the past 12 months, did your [family physician/specialist/nurse practitioner/regular health care provider?] advise you to reduce or quit smoking?

  • 1: Yes
  • 2: No
  • 3: Did not see or talk to him or her
  • 8: RF
  • 9: DK

Consultations with health professionals on smoking (SPC) - Question identifier:SPC_Q015

In the past 12 months, did your [family physician/specialist/nurse practitioner/regular health care provider?] give you any specific help or information to reduce or quit smoking?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Consultations with health professionals on smoking (SPC) - Question identifier:SPC_Q020

What type of help did the [family physician/specialist/nurse practitioner/regular health care provider?] give?

  • 01: Referral to a one-on-one cessation program
  • 02: Referral to a group cessation program
  • 03: Recommended use of nicotine patch or nicotine gum
  • 04: Recommended Zyban or other medication
  • 05: Provided self-help information (e.g., pamphlet, referral to website)
  • 06: Referral to a 1-800 telephone quit line or other smoker help lines
  • 07: Family physician offered counselling
  • 08: Other
  • 98: RF
  • 99: DK

Consultations with health professionals on smoking (SPC) - Question identifier:SPC_Q025

Does your dental professional know that you [smoke / smoked] cigarettes?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Consultations with health professionals on smoking (SPC) - Question identifier:SPC_Q030

In the past 12 months, did your dental professional advise you to reduce or quit smoking?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Consultations with health professionals on smoking (SPC) - Question identifier:SPC_Q035

In the past 12 months, did your dental professional give you any specific help or information to reduce or quit smoking?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Consultations with health professionals on smoking (SPC) - Question identifier:SPC_Q040

What type of help did the dental professional give?

  • 01: Referral to a one-on-one cessation program
  • 02: Referral to a group cessation program
  • 03: Recommended use of nicotine patch or nicotine gum
  • 04: Recommended Zyban or other medication
  • 05: Provided self-help information (e.g., pamphlet, referral to website)
  • 06: Referral to a 1-800 telephone quit line or other smoker help lines
  • 07: Dentist offered counselling
  • 08: Other
  • 98: RF
  • 99: DK

Consultations with health professionals on smoking (SPC) - Question identifier:SPC_Q045

In the past 12 months, have you asked a pharmacist for advice to help you to reduce or quit smoking?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Consultations with health professionals on smoking (SPC) - Question identifier:SPC_Q050

What type of help did the pharmacist give?

  • 1: Referral to a one-on-one cessation program
  • 2: Referral to a group cessation program
  • 3: Recommended use of nicotine patch or nicotine gum
  • 4: Recommended Zyban or other medication
  • 5: Provided self-help information (e.g., pamphlet, referral to website)
  • 6: Referral to a 1-800 telephone quit line or other smoker help lines
  • 7: Other
  • 8: RF
  • 9: DK

Patient experiences (PEX)

Patient experiences (PEX) - Question identifier:PEX_R001

The next questions are about your last consultation with a health professional.

Patient experiences (PEX) - Question identifier:PEX_Q005

When was the last time that you had a consultation with any health professional about your own health? Exclude care you got when you stayed overnight in a hospital, dental care visits, accident or emergency care, or care received in your home.

  • 1: In the last 30 days
  • 2: Between 1 and 3 months ago
  • 3: More than 3 but less than 6 months ago
  • 4: Between 6 and 12 months ago
  • 5: Between 1 and 2 years ago
  • 6: More than 2 years ago
  • 8: RF
  • 9: DK

Patient experiences (PEX) - Question identifier:PEX_Q010

Thinking about this last consultation, who did you receive care from?

  • 1: A general practitioner or family doctor
  • 2: A medical specialist
  • 3: A nurse
  • 4: Another health professional, such as a physiotherapist, psychologist or a speech therapist
  • 8: RF
  • 9: DK

Patient experiences (PEX) - Question identifier:PEX_Q015

Where did this last consultation take place?

  • 01: At a doctor's office working in solo practice
  • 02: At a doctor's office working in a team practice
  • 03: At an office with many doctors working independently
  • 04: At a hospital outpatient clinic
  • 05: At a community health centre [or CLSC/null]
  • 06: At a walk-in clinic
  • 07: At a hospital emergency room
  • 08: Over the telephone (for example [Info-Santé/Telehealth Ontario/HealthLinks/Health-Line/Telecare/on a health info line])
  • 09: Other
  • 98: RF
  • 99: DK

Patient experiences (PEX) - Question identifier:PEX_Q020

Is this the place that you usually go to for most of your immediate care for a minor health problem?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Patient experiences (PEX) - Question identifier:PEX_Q025

Did you need to make an appointment to obtain this last consultation?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Patient experiences (PEX) - Question identifier:PEX_Q030

How quickly did you get this appointment?

  • 1: On the same day
  • 2: The next day
  • 3: In 2 to 3 days
  • 4: In 4 to 6 days
  • 5: In 1 to 2 weeks
  • 6: Between 2 weeks and one month
  • 7: One month or more
  • 8: RF
  • 9: DK

Patient experiences (PEX) - Question identifier:PEX_Q035

Was the time you waited for the appointment a problem for you?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Patient experiences (PEX) - Question identifier:PEX_Q040

Were you seen by the [general practitioner / medical specialist / nurse / health professional] at the scheduled time of your appointment?

  • 1: Appointment was on time or sooner than scheduled
  • 2: Appointment was late
  • 8: RF
  • 9: DK

Patient experiences (PEX) - Question identifier:PEX_Q045

How long did you wait between the time of your appointment and the time you were seen by the [general practitioner / medical specialist / nurse / health professional]?

  • 1: Less than 15 minutes
  • 2: 15 to less than 30 minutes
  • 3: 30 minutes to less than one hour
  • 4: 1 to less than 2 hours
  • 5: 2 hours or more
  • 8: RF
  • 9: DK

Patient experiences (PEX) - Question identifier:PEX_Q050

Was the time you waited a problem for you?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Patient experiences (PEX) - Question identifier:PEX_Q055

Did the [general practitioner / medical specialist / nurse / health professional] spend enough time with you during this last consultation?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Patient experiences (PEX) - Question identifier:PEX_Q060

Was your blood pressure measured (during this last consultation)?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Patient experiences (PEX) - Question identifier:PEX_Q065

Did this [general practitioner / medical specialist / nurse / health professional] explain things in a way that was easy to understand?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Patient experiences (PEX) - Question identifier:PEX_Q070

Did this [general practitioner / medical specialist / nurse / health professional] give you an opportunity to ask questions or raise concerns about your care or recommended treatment?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Patient experiences (PEX) - Question identifier:PEX_Q075

Did this [general practitioner / medical specialist / nurse / health professional] involve you as much as you could have been in decisions about your care or treatment?

  • 1: Yes
  • 2: No
  • 3: Did not want to be involved
  • 8: RF
  • 9: DK

Patient experiences (PEX) - Question identifier:PEX_Q080

Did this [general practitioner / medical specialist / nurse / health professional] tell you how much the recommended treatment would cost, or whether any lower cost alternatives were available?

  • 1: Yes
  • 2: No
  • 3: Not applicable, no recommended treatment or no cost implications
  • 8: RF
  • 9: DK

Patient experiences (PEX) - Question identifier:PEX_Q085

Overall, how would you rate the quality of this consultation?

  • 1: Excellent
  • 2: Very good
  • 3: Good
  • 4: Fair
  • 5: Poor
  • 8: RF
  • 9: DK

Patient experiences (PEX) - Question identifier:PEX_R090

Now, a question about prescriptions for medicine.

Patient experiences (PEX) - Question identifier:PEX_Q090

During the last 12 months, was there a time when you did not fill or collect a prescription for medicine, or you skipped doses of your medicine because of the cost?

  • 1: Yes
  • 2: No
  • 3: Not applicable, I had no medication prescription to fill in the last 12 months
  • 8: RF
  • 9: DK

Home care services - with palliative care (HMC)

Home care services - with palliative care (HMC) - Question identifier:HMC_R005

Now some questions on home care services that you [or anyone in the household] may have received because of a health condition or a limitation in daily activities. These include services provided in your own home such as nursing care, meal preparation, someone to help with bathing or housework, etc. Do not include the help from family, friends or neighbours.

Home care services - with palliative care (HMC) - Question identifier:HMC_Q005

In the past 12 months, what type of home care services have you [or anyone in the household] received?

  • 1: Nursing care (e.g., dressing changes, preparing
    medications, V.O.N. visits)
  • 2: Other health care services (e.g., physiotherapy,
    occupational or speech therapy, nutrition counselling)
  • 3: Medical equipment or supplies (e.g., wheelchair, pads for incontinence, help with using a ventilator or oxygen equipment)
  • 4: Personal or home support (such as bathing, housekeeping, meal preparation)
  • 5: Palliative or end-of-life care
  • 6: Other services (such as transportation, meals-on-wheels)
  • 7: No one in the household received any home care services
  • 8: RF
  • 9: DK

Home care services - with palliative care (HMC) - Question identifier:HMC_Q010

Were [the nursing care / the other health care / the medical equipment or supplies / the personal or home support / the palliative care / the other] services provided for yourself or someone else living in the household?

  • 1: Home care provided to selected respondent only
  • 2: Home care provided to other household member only
  • 3: Home care provided to selected respondent and other household member
  • 8: RF
  • 9: DK

Home care services - with palliative care (HMC) - Question identifier:HMC_R015

For the next two questions please only report for the home care services provided for you.

Home care services - with palliative care (HMC) - Question identifier:HMC_Q015

How long have [you / other household members] been receiving [the nursing care / the other health care / the medical equipment or supplies / the personal or home support / the palliative care / the other] services?

  • 1: Less than 1 month
  • 2: 1 month to less than 3 months
  • 3: 3 months to less than 6 months
  • 4: 6 months to less than 1 year
  • 5: 1 year to 3 years
  • 6: More than 3 years
  • 8: RF
  • 9: DK

Home care services - with palliative care (HMC) - Question identifier:HMC_Q020

In a typical month over the past 12 months, how much have [you / other household members] paid for [the nursing care / the other health care / the medical equipment or supplies / the personal or home support / the palliative care / the other] services?

  • 01: $0
  • 02: $1 to less than $50
  • 03: $50 to less than $100
  • 04: $100 to less than $200
  • 05: $200 to less than $300
  • 06: $300 to less than $400
  • 07: $400 to less than $1000
  • 08: $1000 and more
  • 98: RF
  • 99: DK

Home care services - with palliative care (HMC) - Question identifier:HMC_Q025

Who paid for these services?

  • 1: Out of your / their own pocket
  • 2: Family or friend living in the same household
  • 3: Someone living outside the household (e.g., family, friends, volunteer organization)
  • 4: Insurance
  • 5: Government
  • 6: Other
  • 8: RF
  • 9: DK

Home care services - with palliative care (HMC) - Question identifier:HMC_Q030

Overall, how satisfied [were you / were the other household members] with the home care services received?

[were you / were the other household members]...?

  • 1: Very satisfied
  • 2: Somewhat satisfied
  • 3: Neither satisfied nor dissatisfied
  • 4: Somewhat dissatisfied
  • 5: Very dissatisfied
  • 8: RF
  • 9: DK

Home care services - with palliative care (HMC) - Question identifier:HMC_Q035

What are the reasons why [you were / the other household members were] not satisfied?

  • 1: Poor quality (i.e. concerns about provider competence, reliability of services, etc.)
  • 2: Services did not address perceived needs
  • 3: Services provided were insufficient
  • 4: Long wait times to receive services
  • 5: Other reason
  • 8: RF
  • 9: DK

Home care services - with palliative care (HMC) - Question identifier:HMC_Q040

During the past 12 months, was there ever a time when [you or anyone in your household] felt that home care services were needed but were not received?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Home care services - with palliative care (HMC) - Question identifier:HMC_Q045

Were these (home care) services needed for yourself or someone else living in the household?

  • 1: Selected Respondent only
  • 2: Other household member only
  • 3: Selected respondent and other household member
  • 8: RF
  • 9: DK

Home care services - with palliative care (HMC) - Question identifier:HMC_R050

For the following questions, please only report for the home care services you (personally) needed.

Home care services - with palliative care (HMC) - Question identifier:HMC_Q050

Thinking of the most recent time, what type of home care was needed?

  • 1: Nursing care (e.g., dressing changes, preparing
    medications, V.O.N. visits)
  • 2: Other health care services (e.g., physiotherapy,
    occupational or speech therapy, nutrition counselling)
  • 3: Medical equipment or supplies (e.g., wheelchair, pads for incontinence, help with using a ventilator or oxygen equipment)
  • 4: Personal or home support (such as bathing, housekeeping, meal preparation)
  • 5: Palliative or end-of-life care
  • 6: Other services (such as transportation, meals-on-wheels)
  • 8: RF
  • 9: DK

Home care services - with palliative care (HMC) - Question identifier:HMC_Q055

Again, thinking of the most recent time, why didn't [you / they] get these services?

  • 01: Not available in the area
  • 02: Not available at time required (e.g., inconvenient hours)
  • 03: Waiting time too long
  • 04: Cost
  • 05: Didn't get around to it / didn't bother
  • 06: Didn't know where to go / call
  • 07: Language barrier
  • 08: Decided not to seek services
  • 09: Doctor did not think it was necessary
  • 10: Not eligible for home care
  • 11: Still waiting for home care
  • 12: Other
  • 98: RF
  • 99: DK

Home care services - with palliative care (HMC) - Question identifier:HMC_Q060

Where did [you / they] try to get these home care services?

  • 1: A government Home Care Program (e.g., CLSC in Quebec, CCAC in Ontario, Extramural Program in New Brunswick)
  • 2: A private agency
  • 3: A family member, friend or neighbour
  • 4: A volunteer organization
  • 5: Nowhere - did not try to get service
  • 6: Other
  • 8: RF
  • 9: DK

Unmet health care needs (UCN)

Unmet health care needs (UCN) - Question identifier:UCN_Q005

During the past 12 months, was there ever a time when you felt that you needed health care, other than homecare services, but you did not receive it?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Unmet health care needs (UCN) - Question identifier:UCN_Q010

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

  • 01: Care not available in the area
  • 02: Care not available at time required (e.g., doctor busy, away from office or no longer at that practice, inconvenient hours)
  • 03: Do not have a regular health care provider
  • 04: Waiting time too long
  • 05: Appointment was cancelled
  • 06: Felt would receive inadequate care
  • 07: Cost
  • 08: Decided not to seek care
  • 09: Doctor didn't think it was necessary
  • 10: Transportation issue
  • 11: Other
  • 98: RF
  • 99: DK

Unmet health care needs (UCN) - Question identifier:UCN_Q015

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

  • 01: Treatment of a chronic physical health condition diagnosed by a health professional
  • 02: Treatment of a chronic mental health condition diagnosed by a health professional
  • 03: Treatment of an acute infectious disease (e.g., cold, flu and stomach flu)
  • 04: Treatment of an acute physical condition (non-infectious)
  • 05: Treatment of an acute mental health condition (e.g., acute stress reaction)
  • 06: A regular check-up (including pre-natal care)
  • 07: Care of an injury
  • 08: Dental care
  • 09: Medication / Prescription refill
  • 10: Other
  • 98: RF
  • 99: DK

Unmet health care needs (UCN) - Question identifier:UCN_Q020

Did you actively try to obtain the health care that was needed?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Unmet health care needs (UCN) - Question identifier:UCN_Q025

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

  • 1: A doctor's office
  • 2: A hospital outpatient clinic
  • 3: A community health centre [or CLSC]
  • 4: A walk-in clinic
  • 5: An emergency department or emergency room
  • 6: Other
  • 8: RF
  • 9: DK

Labour force (LBF)

Labour force (LBF) - Question identifier:LBF_Q005A

Many of the following questions concern your activities last week. By last week, I mean the week beginning on [First day of reference week], and ending [Last day of reference week].

Last week, did you work at a job or business? (regardless of the number of hours)

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Labour force (LBF) - Question identifier:LBF_Q005B

Last week, did you have a job or business from which you were absent?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Labour force (LBF) - Question identifier:LBF_Q005C

What was the main reason you were absent from work last week?

  • 01: Own illness or disability
  • 02: Caring for own children
  • 03: Caring for elder relative (60 years of age or older)
  • 04: Maternity or parental leave
  • 05: Other personal or family responsibilities
  • 06: Vacation
  • 07: Labour dispute (strike or lockout) (Employees only)
  • 08: Temporary layoff due to business conditions (Employees only)
  • 09: Seasonal layoff (Employees only)
  • 10: Casual job, no work available (Employees only)
  • 11: Work schedule (e.g., shift work) (Employees only)
  • 12: Self-employed, no work available (Self-employed only)
  • 13: Seasonal business (Excluding employees)
  • 14: Other - Specify
  • 98: RF
  • 99: DK

Labour force (LBF) - Question identifier:LBF_R010

The next questions are about your current job or business.

Labour force (LBF) - Question identifier:LBF_Q010

Were you an employee or self-employed?

  • 1: Employee
  • 2: Self-employed
  • 3: Working in a family business without pay
  • 8: RF
  • 9: DK

Labour force (LBF) - Question identifier:LBF_Q015A

What was the name of your business?

Long Answer Length = 50

Labour force (LBF) - Question identifier:LBF_Q015B

For whom did you work?

Long Answer Length = 50

Labour force (LBF) - Question identifier:LBF_Q015C

What kind of business, industry or service was this?

Long Answer Length = 50

Labour force (LBF) - Question identifier:LBF_Q020A

What was your work or occupation?

Long Answer Length = 50

Labour force (LBF) - Question identifier:LBF_Q020B

In this work, what were your main activities?

Long Answer Length = 50

Labour force (LBF) - Question identifier:LBF_Q025

On average, how many hours do you usually work per week?

Min = 0.0; Max = 168.0

Labour force (LBF) - Question identifier:LBF_Q030

Did you have more than one job or business last week?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Labour force (LBF) - Question identifier:LBF_Q035

On average, how many hours do you usually work per week at your other job(s)?

Min = 1; Max = 168

Socio-demographic characteristics (SDC)

Socio-demographic characteristics (SDC) - Question identifier:SDC_R001

Now, some general questions which will help us compare the health of people in Canada.

Socio-demographic characteristics (SDC) - Question identifier:SDC_Q005A

In what country were you born?

  • 1: Search
  • 3: Other - Specify
  • 8: RF
  • 9: DK

Socio-demographic characteristics (SDC) - Question identifier:SDC_Q005B

In which province or territory were you born?

  • 10: Newfoundland and Labrador
  • 11: Prince Edward Island
  • 12: Nova Scotia
  • 13: New Brunswick
  • 24: Quebec
  • 35: Ontario
  • 46: Manitoba
  • 47: Saskatchewan
  • 48: Alberta
  • 59: British Columbia
  • 60: Yukon
  • 61: Northwest Territories
  • 62: Nunavut
  • 98: RF
  • 99: DK

Socio-demographic characteristics (SDC) - Question identifier:SDC_Q005C

Are you now, or have you ever been a landed immigrant in Canada?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Socio-demographic characteristics (SDC) - Question identifier:SDC_Q005D

In what year did you first become a landed immigrant in Canada?

Min = 1870; Max = 2100

Socio-demographic characteristics (SDC) - Question identifier:SDC_Q010

To which ethnic or cultural groups did your ancestors belong? (For example: French, Scottish, Chinese, East Indian)

  • 01: Canadian
  • 02: French
  • 03: English
  • 04: German
  • 05: Scottish
  • 06: Irish
  • 07: Italian
  • 08: Ukrainian
  • 09: Dutch (Netherlands)
  • 10: Chinese
  • 11: Jewish
  • 12: Polish
  • 13: Portuguese
  • 14: South Asian (e.g., East Indian, Pakistani, Sri Lankan)
  • 15: Norwegian
  • 16: Welsh
  • 17: Swedish
  • 18: First Nations (North American Indian)
  • 19: Métis
  • 20: Inuit
  • 21: Other - Specify
  • 98: RF
  • 99: DK

Socio-demographic characteristics (SDC) - Question identifier:SDC_Q015A

Are you an Aboriginal person, that is, First Nations, Métis or Inuk (Inuit)? First Nations includes Status and Non-Status Indians.

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Socio-demographic characteristics (SDC) - Question identifier:SDC_Q015B

Are you First Nations, Métis or Inuk (Inuit)?

  • 1: First Nations (North American Indian)
  • 2: Métis
  • 3: Inuk (Inuit)
  • 8: RF
  • 9: DK

Socio-demographic characteristics (SDC) - Question identifier:SDC_Q020

You may belong to one or more racial or cultural groups on the following list. Are you... ?

  • 01: White
  • 02: South Asian (e.g., East Indian, Pakistani, Sri Lankan)
  • 03: Chinese
  • 04: Black
  • 05: Filipino
  • 06: Latin American
  • 07: Arab
  • 08: Southeast Asian (e.g., Vietnamese, Cambodian,
    Malaysian, Laotian)
  • 09: West Asian (e.g., Iranian, Afghan)
  • 10: Korean
  • 11: Japanese
  • 12: Other - Specify
  • 98: RF
  • 99: DK

Socio-demographic characteristics (SDC) - Question identifier:SDC_Q025A

Of English or French, which language(s) do you speak well enough to conduct a conversation? Is it... ?

  • 1: English only
  • 2: French only
  • 3: Both English and French
  • 4: Neither English nor French
  • 8: RF
  • 9: DK

Socio-demographic characteristics (SDC) - Question identifier:SDC_Q025B

What language do you speak most often at home?

Long Answer Length = 80

Socio-demographic characteristics (SDC) - Question identifier:SDC_Q025C

What is the language that you first learned at home in childhood and still understand?

Long Answer Length = 80

Socio-demographic characteristics (SDC) - Question identifier:SDC_Q027

Have you ever served in the Canadian military?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Socio-demographic characteristics (SDC) - Question identifier:SDC_R030

Now a question about the dwelling in which you live.

Socio-demographic characteristics (SDC) - Question identifier:SDC_Q030

Is this dwelling...?

  • 1: Owned by you or a member of this household, even if it is still being paid for
  • 2: Rented, even if no cash rent is paid
  • 8: RF
  • 9: DK

Socio-demographic characteristics (SDC) - Question identifier:SDC_R035

Now, one additional background question which will help us compare the health of people in Canada.

Socio-demographic characteristics (SDC) - Question identifier:SDC_Q037

What is your sexual orientation?

  • 1: Heterosexual
  • 2: Homosexual
  • 3: Bisexual
  • 4: Or please specify
  • 8: RF
  • 9: DK

Person most knowledgeable about household situation (PMK)

Person most knowledgeable about household situation (PMK) - Question identifier:PMK_R010

For the last few questions, I would like to speak with someone who would be best able to answer questions about the entire household such as household income and food purchases.

Person most knowledgeable about household situation (PMK) - Question identifier:PMK_Q010

Who would this person be?

  • 01: MEMBER1
  • 02: MEMBER2
  • 03: MEMBER3
  • 04: MEMBER4
  • 05: MEMBER5
  • 06: MEMBER6
  • 07: MEMBER7
  • 08: MEMBER8
  • 09: MEMBER9
  • 10: MEMBER10
  • 11: MEMBER11
  • 12: MEMBER12
  • 13: MEMBER13
  • 14: MEMBER14
  • 15: MEMBER15
  • 16: MEMBER16
  • 17: MEMBER17
  • 18: MEMBER18
  • 19: MEMBER19
  • 20: MEMBER20

Person most knowledgeable about household situation (PMK) - Question identifier:PMK_Q015

Is [MEMBER#] available?

  • 1: Yes
  • 2: No
  • 3: Person most knowledgeable about household refuses to participate.

Person most knowledgeable about household situation (PMK) - Question identifier:PMK_R025

This completes your portion of the interview. On behalf of Statistics Canada, I would like to thank you very much for your time.

Person most knowledgeable about household situation (PMK) - Question identifier:PMK_R030

This completes your portion of the interview. On behalf of Statistics Canada, I would like to thank you very much for your time. I would now like to try and find the best time to speak with [MEMBER#].

Person most knowledgeable about household situation (PMK) - Question identifier:PMK_R035

This completes your portion of the interview. On behalf of Statistics Canada, I would like to thank you very much for your time. I would now like to speak with [MEMBER#].

Person most knowledgeable about household situation (PMK) - Question identifier:PMK_R040

Hello, My name is... I've just completed the main portion of the interview with <Respondent's name>. At this point I need to finish the interview with a few general questions on your household's situation. <Respondent's name> said you would be the best person to answer these types of questions.

Health insurance coverage (INS)

Health insurance coverage (INS) - Question identifier:INS_R001

Now, turning to your health insurance coverage. Please include any private, government or employer-paid plans.

Health insurance coverage (INS) - Question identifier:INS_Q005

Do you have insurance that covers all or part of the cost of your prescription medications?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Health insurance coverage (INS) - Question identifier:INS_Q010

Is it...?

  • 1: A government-sponsored plan
  • 2: An employer-sponsored benefit plan
  • 3: A plan sponsored through an association such as a union, trade association or student organization
  • 4: Other, such as your own private plan purchased from an insurance company
  • 8: RF
  • 9: DK

Health insurance coverage (INS) - Question identifier:INS_Q015

Do you have insurance that covers all or part of your long-term care costs, including home care?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Health insurance coverage (INS) - Question identifier:INS_Q020

Is it...?

  • 1: A government-sponsored plan
  • 2: An employer-sponsored benefit plan
  • 3: A plan sponsored through an association such as a union, trade association or student organization
  • 4: Other, such as your own private plan purchased from an insurance company
  • 8: RF
  • 9: DK

Prescriptions - cost-related non-adherence - short version (PCN2)

Prescriptions - cost-related non-adherence - short version (PCN2) - Question identifier:PCN2_Q003

Do you have insurance that covers all or part of the cost of your prescription medications? Please include any private, government or employer-paid plans.

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Prescriptions - cost-related non-adherence - short version (PCN2) - Question identifier:PCN2_Q005

During the last 12 months, was there a time when you did not fill or collect a prescription for your medicine, or you skipped doses of your medicine because of the cost?

  • 1: Yes
  • 2: No
  • 3: Not applicable, [I] had no medication prescription to fill in the last 12 months
  • 8: RF
  • 9: DK

Prescriptions - cost-related non-adherence - short version (PCN2) - Question identifier:PCN2_Q010

In the last 12 months, was there a time when you reduced the dosage of your medication or delayed filling your prescription, because of the cost?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Food security (FSC)

Food security (FSC) - Question identifier:FSC_R010

The following questions are about the food situation for your household in the past 12 months. I'm going to read you several statements that may be used to describe the food situation for a household. Please tell me if the statement was often true, sometimes true, or never true for you [and other household members] in the past 12 months.

Food security (FSC) - Question identifier:FSC_Q010

The first statement is: You [and other household members] worried that food would run out before you got money to buy more. Was that often true, sometimes true, or never true in the past 12 months?

  • 1: Often true
  • 2: Sometimes true
  • 3: Never true
  • 8: RF
  • 9: DK

Food security (FSC) - Question identifier:FSC_Q015

The food that you [and other household members] bought just didn't last, and there wasn't any money to get more. Was that often true, sometimes true, or never true in the past 12 months?

  • 1: Often true
  • 2: Sometimes true
  • 3: Never true
  • 8: RF
  • 9: DK

Food security (FSC) - Question identifier:FSC_Q020

You [and other household members] couldn't afford to eat balanced meals. In the past 12 months was that often true, sometimes true, or never true?

  • 1: Often true
  • 2: Sometimes true
  • 3: Never true
  • 8: RF
  • 9: DK

Food security (FSC) - Question identifier:FSC_R025

Now, I'm going to read a few statements that may describe the food situation for households with children.

Food security (FSC) - Question identifier:FSC_Q025

You [or other adults in your household] relied on only a few kinds of low-cost food to feed [the children] because you were running out of money to buy food. Was that often true, sometimes true, or never true in the past 12 months?

  • 1: Often true
  • 2: Sometimes true
  • 3: Never true
  • 8: RF
  • 9: DK

Food security (FSC) - Question identifier:FSC_Q030

You [or other adults in your household] couldn't feed [the children] a balanced meal, because you couldn't afford it. Was that often true, sometimes true, or never true in the past 12 months?

  • 1: Often true
  • 2: Sometimes true
  • 3: Never true
  • 8: RF
  • 9: DK

Food security (FSC) - Question identifier:FSC_Q035

[The children were] not eating enough because you [or other adults in your household] just couldn't afford enough food. Was that often, sometimes, or never true in the past 12 months?

  • 1: Often true
  • 2: Sometimes true
  • 3: Never true
  • 8: RF
  • 9: DK

Food security (FSC) - Question identifier:FSC_R040

The following few questions are about the food situation in the past 12 months for you or any other adults in your household.

Food security (FSC) - Question identifier:FSC_Q040

In the past 12 months, since last [current month], did you [or other adults in your household] ever cut the size of your meals or skip meals because there wasn't enough money for food?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Food security (FSC) - Question identifier:FSC_Q045

How often did this happen? Was it...?

  • 1: Almost every month
  • 2: Some months but not every month
  • 3: Only 1 or 2 months
  • 8: RF
  • 9: DK

Food security (FSC) - Question identifier:FSC_Q050

In the past 12 months, did you (personally) ever eat less than you felt you should because there wasn't enough money to buy food?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Food security (FSC) - Question identifier:FSC_Q055

In the past 12 months, were you (personally) ever hungry but didn't eat because you couldn't afford enough food?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Food security (FSC) - Question identifier:FSC_Q060

In the past 12 months, did you (personally) ever lose weight because you didn't have enough money for food?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Food security (FSC) - Question identifier:FSC_Q065

In the past 12 months, did [you or other adults in your household] ever not eat for a whole day because there wasn't enough money for food?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Food security (FSC) - Question identifier:FSC_Q070

How often did this happen? Was it...?

  • 1: Almost every month
  • 2: Some months but not every month
  • 3: Only 1 or 2 months
  • 8: RF
  • 9: DK

Food security (FSC) - Question identifier:FSC_R075

Now, a few questions on the food experiences for children in your household.

Food security (FSC) - Question identifier:FSC_Q075

In the past 12 months, did you [or other adults in your household] ever cut the size of [any of the children's] meals because there wasn't enough money for food?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Food security (FSC) - Question identifier:FSC_Q080

In the past 12 months, did [any of the children] ever skip meals because there wasn't enough money for food?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Food security (FSC) - Question identifier:FSC_Q085

How often did this happen? Was it...?

  • 1: Almost every month
  • 2: Some months but not every month
  • 3: Only 1 or 2 months
  • 8: RF
  • 9: DK

Food security (FSC) - Question identifier:FSC_Q090

In the past 12 months, [were any of the children] ever hungry but you just couldn't afford more food?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Food security (FSC) - Question identifier:FSC_Q095

In the past 12 months, did [any of the children] ever not eat for a whole day because there wasn't enough money for food?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Administration information (ADM)

Administration information (ADM) - Question identifier:ADM_Q005

Statistics Canada will combine your responses with information from the tax data of all members of your household. Statistics Canada, your [provincial / territorial] ministry of health [and the "Institut de la Statistique du Québec] may also add information from other surveys or administrative sources.

  • 1: Continue (Go to ADM_D010A)
  • 2: Respondent does not want his or her responses combined with other sources
  • 3: Other [e.g., respondent hung up, interview suspended or interrupted]

Administration information (ADM) - Question identifier:ADM_Q010

Having a provincial or territorial health number will assist us in linking to this other information.

Do you have [a/an] [Name of province/territory] health number?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Administration information (ADM) - Question identifier:ADM_Q015

For which province or territory is your health number?

  • 10: Newfoundland and Labrador
  • 11: Prince Edward Island
  • 12: Nova Scotia
  • 13: New Brunswick
  • 24: Quebec
  • 35: Ontario
  • 46: Manitoba
  • 47: Saskatchewan
  • 48: Alberta
  • 59: British Columbia
  • 60: Yukon
  • 61: Northwest Territories
  • 62: Nunavut
  • 88: Does not have a Canadian health number
  • 98: RF
  • 99: DK

Administration information (ADM) - Question identifier:ADM_Q020

What is your health number?

Long Answer Length = 12

Administration information (ADM) - Question identifier:ADM_R025

To avoid duplication of surveys, Statistics Canada has signed agreements to share the data from this survey with provincial and territorial ministries of health, Health Canada and the Public Health Agency of Canada.

Provincial ministries of health may make the data available to local health authorities. With the exception of postal code, names, addresses, telephone numbers [and health numbers] will not be provided.

Administration information (ADM) - Question identifier:ADM_R030

To avoid duplication of surveys, Statistics Canada has signed agreements to share the data from this survey with provincial and territorial ministries of health, the "Institut de la Statistique du Québec", Health Canada and the Public Health Agency of Canada.

The "Institut de la Statistique du Québec" and provincial ministries of health may make this data available to local health authorities. With the exception of postal code, names, addresses, telephone numbers [and health numbers] will not be provided.

Administration information (ADM) - Question identifier:ADM_Q035

These organizations have agreed to keep the data confidential and use it only for statistical purposes.

Do you agree to share the data provided?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Administration information (ADM) - Question identifier:ADM_Q037

To reduce the number of questions in this questionnaire, Statistics Canada will use information from your tax forms submitted to the Canada Revenue Agency. With your consent Statistics Canada will share this information from your tax forms with provincial and territorial ministries of health, [the "Institut de la Statistique du Québec",] Health Canada and the Public Health Agency of Canada. These organizations have agreed to keep the information confidential and to use it only for statistical and research purposes.

Do you give Statistics Canada permission to share your tax information to provincial and territorial ministries of health, [the "Institut de la Statistique du Québec",] Health Canada and the Public Health Agency of Canada?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Income (INC)

Income (INC) - Question identifier:INC_R001

Although many health expenses are covered by health insurance, there is still an important relationship between health and income. Please be assured that, like all other information you have provided, these answers will be kept strictly confidential.

Income (INC) - Question identifier:INC_Q005

Thinking about the total income for all household members, from which of the following sources did your household receive any income in the year ending December 31, [Past year]?

  • 01: Wages and salaries
  • 02: Income from self-employment
  • 03: Dividends and interest (e.g., on bonds, savings)
  • 04: Employment insurance
  • 05: Workers' compensation
  • 06: Benefits from Canada or Quebec Pension Plan
  • 07: Job-related retirement pensions, superannuation and annuities
  • 08: RRSP/RRIF (Registered Retirement Savings Plan/Registered Retirement Income Fund)
  • 09: Old Age Security and Guaranteed Income Supplement
  • 10: Provincial or municipal social assistance or welfare
  • 11: Child Tax Benefit or family allowances
  • 12: Child support
  • 13: Alimony
  • 14: Other (e.g., rental income, scholarships)
  • 15: None
  • 98: RF
  • 99: DK

Income (INC) - Question identifier:INC_Q010

Does this amount include a supplement for people with disabilities?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Income (INC) - Question identifier:INC_Q015

What was the main source of household income?

  • 01: Wages and salaries
  • 02: Income from self-employment
  • 03: Dividends and interest (e.g., on bonds, savings)
  • 04: Employment insurance
  • 05: Workers' compensation
  • 06: Benefits from Canada or Quebec Pension Plan
  • 07: Job-related retirement pensions, superannuation and annuities
  • 08: RRSP/RRIF (Registered Retirement Savings Plan/Registered Retirement Income Fund)
  • 09: Old Age Security and Guaranteed Income Supplement
  • 10: Provincial or municipal social assistance or welfare
  • 11: Child Tax Benefit or family allowances
  • 12: Child support
  • 13: Alimony
  • 14: Other (e.g., rental income, scholarships)
  • 15: None
  • 98: RF
  • 99: DK

Income (INC) - Question identifier:INC_Q021

Now a question about your total household income.

What is your best estimate of your total household income received by all household members, from all sources, before taxes and deductions, during the year ending December 31, [Past year] ?

Income can come from various sources such as from work, investments, pensions or government. Examples include Employment Insurance, Social Assistance, Child Tax Benefit and other income such as child support, spousal support (alimony) and rental income.

Min = -9000000; Max = 90000000

Income (INC) - Question identifier:INC_Q022

Can you estimate in which of the following groups your household income falls? Was the total household income during the year ending December 31, [Past year]... ?

  • 1: Less than $50,000, including income loss
  • 2: $50,000 and more
  • 8: RF
  • 9: DK

Income (INC) - Question identifier:INC_Q023

Please stop me when I have read the category which applies to your household.

Was it... ?

  • 1: Less than $5,000
  • 2: $5,000 to less than $10,000
  • 3: $10,000 to less than $15,000
  • 4: $15,000 to less than $20,000
  • 5: $20,000 to less than $30,000
  • 6: $30,000 to less than $40,000
  • 7: $40,000 to less than $50,000
  • 8: RF
  • 9: DK

Income (INC) - Question identifier:INC_Q024

Please stop me when I have read the category which applies to your household.

Was it... ?

  • 1: $50,000 to less than $60,000
  • 2: $60,000 to less than $70,000
  • 3: $70,000 to less than $80,000
  • 4: $80,000 to less than $90,000
  • 5: $90,000 to less than $100,000
  • 6: $100,000 to less than $150,000
  • 7: $150,000 and over
  • 8: RF
  • 9: DK
Date modified: