Canadian Community Health Survey (CCHS) - Annual Component - 2025

The proxy respondent (PRX) - Question identifier:PRX_Q01

What is the reason [First name of household contact] is unable to complete this survey?

• 1: Respondent does not speak English or French (Language barrier)
• 2: Respondent unable to answer because of a health condition, a physical or mental disability, or problems related to aging
• 3: Respondent absent for the duration of the collection period
• 4: Other

The proxy respondent (PRX) - Question identifier:PRX_Q02

Is there someone [Minimum age of person providing proxy interview] or older who could provide us with some information on behalf of [First name of household contact]? We would like to ask this person questions about [First name of household contact]'s health status, factors that affect their health and their use of health care services.

• 1: Yes
• 2: No

The proxy respondent (PRX) - Question identifier:PRX_Q03A

What is the first name of this person?

Long Answer Length = 80

First name

The proxy respondent (PRX) - Question identifier:PRX_Q03B

What is the last name of this person?

Long Answer Length = 80

Last name

The proxy respondent (PRX) - Question identifier:PRX_Q04

May I speak with [First name of person providing proxy interview] [Last name of person providing proxy interview]?

• 1: Yes, speaking to information provider
• 2: Yes, information provider available
• 3: No, information provider not available to complete this survey
• 4: No, information provider not available at this time

The proxy respondent (PRX) - Question identifier:PRX_Q05

Can you give me a telephone number for [First name of person providing proxy interview] [Last name of person providing proxy interview]?

• 1: Yes
• 2: No

The proxy respondent (PRX) - Question identifier:PRX_Q05A

Enter the telephone number, including area code

Long Answer Length = 10

Telephone number

Respondent availability (TR) - Question identifier:TR_Q01

May I speak to [First name of household contact] [Last name of household contact]?

Respondent availability

• 1: Yes, speaking to respondent
• 2: Yes, respondent available
• 3: No, respondent unable to complete this survey
• 4: No, respondent not available at this time

Date of birth (AGE) - Question identifier:AGE_Q01A

What is [your] date of birth?
Year

Min = 1897; Max = 2022

Date of birth (AGE) - Question identifier:AGE_Q01B

What is [your] date of birth?
Month

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

Date of birth (AGE) - Question identifier:AGE_Q01C

What is [your] date of birth?
Day

Min = 1; Max = 31

Sex and gender (GDRA) - Question identifier:GDRA_R05

The following questions are about sex at birth and gender.

Sex and gender (GDRA) - Question identifier:GDRA_Q05

What was [your] sex at birth?

Sex refers to sex assigned at birth.

• 1: Male
• 2: Female

Sex and gender (GDRA) - Question identifier:GDRA_Q10

What is [your] gender?

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.

• 1: Male
• 2: Female
• 3: Or please specify

Sex and gender (GDRA) - Question identifier:GDRA_R15

Please verify that all of the information is correct.

[Your]

Sex assigned at birth: [Male/Female/Information not provided]
Gender: [Male/Female/Other/Information not provided]

If all the information is correct, press the Next button.
To make changes, press the Previous button.

Marital status (MS) - Question identifier:MS_Q01

What is your marital status?

• 1: Married (For Quebec residents only, select the "Married" category if your marital status is "civil union".)
• 2: Living common law (Two people who live together as a couple but who are not legally married to each other.)
• 3: Never married (not living common law)
• 4: Separated (not living common law)
• 5: Divorced (not living common law)
• 6: Widowed (not living common law)

Relationship with confirmation (RWC) - Question identifier:RWC_Q05

What is the relationship of the following [people/person] to you?

[First name of household member] [Last name of household member] [Age]

• 01: Husband or wife
• 02: Common-law partner
• 03: Father or mother
• 04: Son or daughter
• 05: Brother or sister
• 06: In-law
• 07: Other related
• 08: Unrelated

Relationship with confirmation (RWC) - Question identifier:RWC_Q30

Select the type of relationship.

• 1: Aunt or uncle
• 2: Cousin
• 3: Niece or nephew
• 4: Grandfather or grandmother
• 5: Grandson or granddaughter
• 6: Other relative

Main activity (MA) - Question identifier:MA_Q01

In the past 12 months, did you work at a job or business?

Regardless of the number of hours.

• 1: Yes
• 2: No

Main activity (MA) - Question identifier:MA_Q01A

In the past 12 months, was working at a job or business your main activity?

• 1: Yes
• 2: No

Main activity (MA) - Question identifier:MA_Q02

During the past 12 months, what was your main activity?

If the main activity was "sickness" or "short-term illness", indicate the usual main activity.

• 01: Looking for paid work
• 02: Going to school
• 03: Caring for your children
• 04: Household work
• 05: Retired
• 06: Maternity, paternity or parental leave
• 07: Long term illness
• 08: Volunteering or care-giving other than for your children
• 09: Other

School attendance (EDC) - Question identifier:EDC_Q10

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

Report only attendance for courses that can be used as credits towards a certificate, diploma or degree. Distance learning for credit is included.

• 1: Yes
• 2: No

School attendance (EDC) - Question identifier:EDC_Q20

Are you enrolled as a full-time or part-time student?

Each educational institution classifies students as full-time or part-time depending on the type of program, and the number of courses, credits or hours of instruction.

• 1: Full-time student
• 2: Part-time student

General health (GEN) - Question identifier:GEN_R01

The following question is about 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_Q01

In general, how is your health?

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

General health (GEN) - Question identifier:GEN_Q05

In general, how is your mental health?

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

General health (GEN) - Question identifier:GEN_Q10

Thinking about the amount of stress in your life, how would you describe most of your days?

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

General health (GEN) - Question identifier:GEN_R15

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

General health (GEN) - Question identifier:GEN_Q15

How would you describe most days at work?

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

General health (GEN) - Question identifier:GEN_Q20

How would you describe your sense of belonging to your local community?

• 1: Very strong
• 2: Somewhat strong
• 3: Somewhat weak
• 4: Very weak

Life satisfaction measures (LSM) - Question identifier:LSM_Q01

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?

• 00: Very dissatisfied
• 01: |
• 02: |
• 03: |
• 04: |
• 05: |
• 06: |
• 07: |
• 08: |
• 09: V
• 10: Very satisfied

Mental Health 1 (DIS) - Question identifier:DIS_R01

The following questions deal with feelings you may have had during the past month.

Press the help button (?) for additional information, including a list of mental health resources you may wish to access should you need any support or are in crisis.

Mental Health 1 (DIS) - Question identifier:DIS_Q01B

During the past month, about how often did you feel the following?

Nervous

• 1: All of the time
• 2: Most of the time
• 3: Some of the time
• 4: A little of the time
• 5: None of the time

Mental Health 1 (DIS) - Question identifier:DIS_Q01D

During the past month, about how often did you feel the following?

Hopeless

• 1: All of the time
• 2: Most of the time
• 3: Some of the time
• 4: A little of the time
• 5: None of the time

Mental Health 1 (DIS) - Question identifier:DIS_Q01E

During the past month, about how often did you feel the following?

Restless or fidgety

• 1: All of the time
• 2: Most of the time
• 3: Some of the time
• 4: A little of the time
• 5: None of the time

Mental Health 1 (DIS) - Question identifier:DIS_Q01H

During the past month, about how often did you feel the following?

So depressed that nothing could cheer you up

• 1: All of the time
• 2: Most of the time
• 3: Some of the time
• 4: A little of the time
• 5: None of the time

Mental Health 1 (DIS) - Question identifier:DIS_Q01I

During the past month, about how often did you feel the following?

That everything was an effort

• 1: All of the time
• 2: Most of the time
• 3: Some of the time
• 4: A little of the time
• 5: None of the time

Mental Health 1 (DIS) - Question identifier:DIS_Q01J

During the past month, about how often did you feel the following?

Worthless

• 1: All of the time
• 2: Most of the time
• 3: Some of the time
• 4: A little of the time
• 5: None of the time

Pregnancy (PRS) - Question identifier:PRS_R05

To better understand your health information, it is important to know if you are pregnant.

Pregnancy (PRS) - Question identifier:PRS_Q05

Are you pregnant?

• 1: Yes
• 2: No

Height and weight (HWT) - Question identifier:HWT_Q05A

How tall are you without shoes on?
Feet

Min = 0; Max = 9

Report the height to the nearest inch or centimetre.

Height and weight (HWT) - Question identifier:HWT_Q05B

How tall are you without shoes on?
Inches

Min = 0; Max = 99

Report the height to the nearest inch or centimetre.

Height and weight (HWT) - Question identifier:HWT_Q05C

How tall are you without shoes on?
Centimetres

Min = 0; Max = 999

Report the height to the nearest inch or centimetre.

Height and weight (HWT) - Question identifier:HWT_Q40A

How much do you weigh?
Weight

Min = 0; Max = 999

Report the weight to the nearest pound or kilogram.

Height and weight (HWT) - Question identifier:HWT_Q40B

How much do you weigh?
Pounds or kilograms

Report the weight to the nearest pound or kilogram.

• 1: Pounds
• 2: Kilograms

Multiple chemical sensitivities (MCS) - Question identifier:MCS_R05

Now a few questions about multiple chemical sensitivities (MCS).

MCS is a chronic condition where people experience symptoms from exposure to low levels of multiple unrelated chemicals (such as perfume, scented products, or smoke) at levels that do not cause symptoms in the unaffected population.

Symptoms from exposure include, among others, fatigue, brain fog, asthma, blocked or runny nose, migraines, muscle or joint pain, and itching, burning, watering, or sore eyes.

Multiple chemical sensitivities (MCS) - Question identifier:MCS_Q05

Do you have multiple chemical sensitivities (MCS)?

• 1: Yes
• 2: No

Multiple chemical sensitivities (MCS) - Question identifier:MCS_Q10

Was this diagnosed by a health professional?

• 1: Yes
• 2: No

Multiple chemical sensitivities (MCS) - Question identifier:MCS_Q15

How old were you when the first symptoms appeared?

Min = 0; Max = 999

Age in years

Multiple chemical sensitivities (MCS) - Question identifier:MCS_Q20

How old were you when this was first diagnosed?

Min = 0; Max = 999

Age in years

Chronic pain (CPA) - Question identifier:CPA_R05

Now a few questions about chronic pain. Chronic pain is defined as pain that persists or recurs for more than three months.

Chronic pain (CPA) - Question identifier:CPA_Q05

Do you live with chronic pain?

Include any pain that has persisted or has been recurring for at least three months, such as pain resulting from chronic migraine, cancer, arthritis, a surgery or injury, or another underlying disease or issue; or pain that has persisted or has been recuring for at least three months with no identifying causes.

• 1: Yes
• 2: No

Chronic pain (CPA) - Question identifier:CPA_Q10

Was this chronic pain diagnosed by a health professional?

• 1: Yes
• 2: No

Chronic conditions (CCC) - Question identifier:CCC_R01

The next question is about long-term health conditions. These are 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_Q01

Have you been diagnosed by a health professional with any of the following long-term health conditions?

Do you have:

Include only conditions you are currently experiencing that have lasted or are expected to last six months or more.

Select all that apply.

• 01: Cancer
• 02: Chronic blood disorder (e.g., sickle cell anemia, hemophilia)
• 03: Diabetes (Include type 1, type 2 or gestational diabetes.)
• 04: High blood cholesterol (Select even if controlled by medication.)
• 05: High blood pressure (Select even if controlled by medication.)
• 06: Heart disease (e.g., angina, heart failure)
• 07: Dementia (e.g., Alzheimer's disease, vascular dementia)
• 08: Effects of a stroke
• 09: Neurological disorder (e.g., amyotrophic lateral sclerosis (ALS) or Lou Gehrig's disease, multiple sclerosis (MS), Parkinson's disease, migraine)
• 10: Fibromyalgia
• 11: Chronic fatigue syndrome (CFS) (Include myalgic encephalomyelitis.)
• 12: Eye disease (e.g., glaucoma, cataracts, macular degeneration, retinopathy, blindness, strabismus)
• 13: Ear disease (e.g., hearing impairment, vestibulopathy)
• 14: Asthma
• 15: Chronic bronchitis, emphysema or chronic obstructive pulmonary disease (COPD)
• 16: Sleep apnea
• 17: Bowel disorder (e.g., Crohn's disease, inflammatory bowel disease (IBD))
• 18: Liver disease (e.g., chronic hepatitis)
• 19: Osteoporosis
• 20: Arthritis (e.g., osteoarthritis or arthrosis, rheumatoid arthritis, gout, pseudogout
  Exclude fibromyalgia.)
• 21: Back problems (e.g., scoliosis, kyphosis, degenerative disk disease)
• 22: Chronic kidney disease (Exclude kidney stones or infection.)
• 23: Dermatological conditions (e.g., eczema, psoriasis)
• 24: Other condition - specify
• 25: None of the above

Chronic conditions (CCC) - Question identifier:CCC_Q10

How old were you when you were first diagnosed with diabetes?

Min = 0; Max = 999

Chronic conditions (CCC) - Question identifier:CCC_Q15

Were you pregnant when you were first diagnosed with diabetes?

• 1: Yes
• 2: No

Chronic conditions (CCC) - Question identifier:CCC_Q20

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

• 1: Yes
• 2: No

Chronic conditions (CCC) - Question identifier:CCC_Q26

What type of diabetes were you diagnosed with?

Would you say:

Don't consider pre-diabetes or diabetes that develops during pregnancy (gestational diabetes).
If you do not remember or were not told please select Don't know.

• 1: Type 1 diabetes
• 2: Type 2 diabetes
• 3: Other types of diabetes
• 4: Don't know

Chronic conditions (CCC) - Question identifier:CCC_Q30

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

Was it:

• 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

Chronic conditions (CCC) - Question identifier:CCC_Q35

Do you currently take insulin for your diabetes?

• 1: Yes
• 2: No

Chronic conditions (CCC) - Question identifier:CCC_Q40

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

• 1: Yes
• 2: No

Chronic conditions (CCC) - Question identifier:CCC_Q50

How old were you when you were first diagnosed with cancer?

Min = 0; Max = 999

Chronic conditions (CCC) - Question identifier:CCC_Q55

Have you received treatment for cancer in the past 12 months?

• 1: Yes
• 2: No

Chronic conditions (CCC) - Question identifier:CCC_Q60

What type of cancer were you diagnosed with?

Was it:

Select all that apply.

• 01: Breast
• 02: Prostate
• 03: Colorectal
• 04: Skin - Melanoma
• 05: Skin - Non-melanoma
• 06: Ovarian
• 07: Cervical
• 08: Uterine
• 09: Lung
• 10: Other type of cancer - Specify

Chronic conditions (CCC) - Question identifier:CCC_Q70

How old were you when you were first diagnosed with heart disease?

Min = 0; Max = 999

Chronic conditions (CCC) - Question identifier:CCC_Q85

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

• 1: Yes
• 2: No

Chronic conditions (CCC) - Question identifier:CCC_Q110

How old were you when the first symptoms of fibromyalgia appeared?

Min = 0; Max = 999

Chronic conditions (CCC) - Question identifier:CCC_Q115

How old were you when this was first diagnosed?

Min = 0; Max = 999

Chronic conditions (CCC) - Question identifier:CCC_Q155

How old were you when the first symptoms of chronic fatigue syndrome (CFS) appeared?

Min = 0; Max = 999

Chronic conditions (CCC) - Question identifier:CCC_Q160

How old were you when this was first diagnosed?

Min = 0; Max = 999

Age in years

Chronic conditions (CCC) - Question identifier:CCC_R166

The next question is about long-term mental health conditions, like depression, and neurodevelopmental conditions, like autism. These are 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_Q166

Have you been diagnosed by a health professional with any of the following long-term mental health or neurodevelopmental conditions?

Do you have:

Include only conditions you are currently experiencing that have lasted or are expected to last six months or more.

Select all that apply.

• 01: A mood disorder (e.g., depression, bipolar disorder, mania or dysthymia)
• 02: An anxiety disorder (e.g., phobia, panic disorder or generalized anxiety disorder)
• 03: Obsessive-compulsive disorder (OCD)
• 04: A personality disorder (e.g., borderline personality disorder, antisocial personality disorder)
• 05: Schizophrenia or any other psychosis
• 06: Post-traumatic stress disorder (PTSD)
• 07: An eating disorder (e.g., anorexia, bulimia, or binge eating disorder)
• 08: Attention deficit disorder (ADD) or attention deficit hyperactivity disorder (ADHD)
• 09: Autism, also known as autism spectrum disorder, autistic disorder, Asperger's disorder or pervasive developmental disorder
• 10: Gambling disorder
• 11: A substance use disorder (e.g., alcohol use disorder, cannabis dependence, opioid dependence)
• 12: Other mental heatlh condition— Specify
• 13: None of the above

Chronic conditions (CCC) - Question identifier:CCC_Q171

What type of eating disorder were you diagnosed with?

Was it:

Select all that apply.

• 1: Anorexia
• 2: Bulimia
• 3: Binge eating disorder
• 4: Other eating disorder— specify:

Abilities (WDM) - Question identifier:WDM_R01

The next set of questions asks about your ability to do different activities.

Abilities (WDM) - Question identifier:WDM_Q05

Do you have ifficulty doing any of these activities?

Difficulty seeing, even if wearing glasses

• 1: No difficulty
• 2: Some difficulty
• 3: A lot of difficulty
• 4: Cannot do at all or unable to do

Abilities (WDM) - Question identifier:WDM_Q10

Do you have difficulty doing any of these activities?

Difficulty hearing, even if using a hearing aid

• 1: No difficulty
• 2: Some difficulty
• 3: A lot of difficulty
• 4: Cannot do at all or unable to do

Abilities (WDM) - Question identifier:WDM_Q15

Do you have difficulty doing any of these activities?

Difficulty walking or climbing steps

• 1: No difficulty
• 2: Some difficulty
• 3: A lot of difficulty
• 4: Cannot do at all or unable to do

Abilities (WDM) - Question identifier:WDM_Q20

Do you have difficulty doing any of these activities?

Difficulty remembering or concentrating

• 1: No difficulty
• 2: Some difficulty
• 3: A lot of difficulty
• 4: Cannot do at all or unable to do

Abilities (WDM) - Question identifier:WDM_Q25

Do you have difficulty doing any of these activities?

Difficulty with self-care

e.g., washing all over or dressing.

• 1: No difficulty
• 2: Some difficulty
• 3: A lot of difficulty
• 4: Cannot do at all or unable to do

Abilities (WDM) - Question identifier:WDM_Q30

Do you have difficulty doing any of these activities?

Difficulty communicating when using your usual language

e.g., understanding or being understood

• 1: No difficulty
• 2: Some difficulty
• 3: A lot of difficulty
• 4: Cannot do at all or unable to do

Long-term conditions (LTC) - Question identifier:LTC_Q10

Do you identify as a person with a disability?

• 1: Yes
• 2: No

Moderate physical activity 2 (MPA2) - Question identifier:MPA2_R05

The following questions are about two different types of physical activity.

Moderate physical activity 2 (MPA2) - Question identifier:MPA2_Q05

In the past 7 days, did you use active transportation like walking or cycling to get to places?

Exclude walking, cycling or other activities done purely for leisure. These activities will be asked about later.

Include using active transportation to go to work, school, bus stops, shopping centres or to visit friends.

• 1: Yes
• 2: No

Moderate physical activity 2 (MPA2) - Question identifier:MPA2_Q10A

In the past 7 days, how much time in total did you spend using active transportation to get to places?

Min = 0; Max = 56

Hours per week

Moderate physical activity 2 (MPA2) - Question identifier:MPA2_Q10B

In the past 7 days, how much time in total, did you spend using active transportation to get to places?

Min = 0; Max = 55

Minutes per week

Moderate physical activity 2 (MPA2) - Question identifier:MPA2_Q15

[Not including activities you just reported, in] the past 7 days, did you do sports, fitness or recreational physical activities?

Include organized or non-organized activities. e.g., home or gym exercise, cycling, running, skiing, team sports, walking for exercise or fitness.

• 1: Yes
• 2: No

Moderate physical activity 2 (MPA2) - Question identifier:MPA2_Q20

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

• 1: Yes
• 2: No

Moderate physical activity 2 (MPA2) - Question identifier:MPA2_Q25A

^NOTINCLUDING_E the past 7 days, how much time in total, did you spend doing sports, fitness or recreationl physical activities that made you sweat at least a little and breathe harder?

Min = 0; Max = 56

Hours per week

Moderate physical activity 2 (MPA2) - Question identifier:MPA2_Q25B

^NOTINCLUDING_E the past 7 days, how much time in total, did you spend doing sports, fitness or recreationl physical activities that made you sweat at least a little and breathe harder?

Min = 0; Max = 55

Minutes per week

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?

Include mobile devices, computers, tablets, video game consoles or TV.

• 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

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?

Include mobile devices, computers, tablets, video game consoles or TV.

• 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

Activities of daily living (ADL) - Question identifier:ADL_R01

These questions may not apply to you, but we need to ask the same questions of everyone.

Activities of daily living (ADL) - Question identifier:ADL_Q05

Because of any health problem, physical or mental condition, do you have any difficulty with the following common daily activities?

Preparing meals

• 1: No difficulty
• 2: Some difficulty, but no help required
• 3: Some difficulty and help from others is required
• 4: Cannot do at all

Activities of daily living (ADL) - Question identifier:ADL_Q10

Because of any health problem, physical or mental condition, do you have any difficulty with the following common daily activities?

Running errands

e.g., shopping for groceries

• 1: No difficulty
• 2: Some difficulty, but no help required
• 3: Some difficulty and help from others is required
• 4: Cannot do at all

Activities of daily living (ADL) - Question identifier:ADL_Q15

Because of any health problem, physical or mental condition, do you have any difficulty with the following common daily activities?

Everyday housework

• 1: No difficulty
• 2: Some difficulty, but no help required
• 3: Some difficulty and help from others is required
• 4: Cannot do at all

Activities of daily living (ADL) - Question identifier:ADL_Q20

Because of any health problem, physical or mental condition, do you have any difficulty with the following common daily activities?

Personal care

e.g., bathing, dressing, eating or taking medication

• 1: No difficulty
• 2: Some difficulty, but no help required
• 3: Some difficulty and help from others is required
• 4: Cannot do at all

Activities of daily living (ADL) - Question identifier:ADL_Q25

Because of any health problem, physical or mental condition, do you have any difficulty with the following common daily activities?

Moving inside the house

• 1: No difficulty
• 2: Some difficulty, but no help required
• 3: Some difficulty and help from others is required
• 4: Cannot do at all

Activities of daily living (ADL) - Question identifier:ADL_Q30

Because of any health problem, physical or mental condition, do you have any difficulty with the following common daily activities?

Personal finances

e.g., making transactions or paying bills

• 1: No difficulty
• 2: Some difficulty, but no help required
• 3: Some difficulty and help from others is required
• 4: Cannot do at all

Eating habits (EAH) - Question identifier:EAH_R01

The next questions are about some of your eating and drinking habits.

Eating habits (EAH) - Question identifier:EAH_Q05A

In the past 30 days, how many times did you eat food from a restaurant?

Min = 0; Max = 999

Include fast-food, take-out, sit-down restaurants or prepared food from grocery stores.

Frequency can be reported per month, per week or per day.

Eating habits (EAH) - Question identifier:EAH_Q05B

In the past 30 days, how many times did you eat food from a restaurant?

Per month, per week or per day

Include fast-food, take-out, sit-down restaurants or prepared food from grocery stores.

Frequency can be reported per month, per week or per day.

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

Eating habits (EAH) - Question identifier:EAH_Q10A

In the past 30 days, how many times did you drink the following beverages?

100% pure fruit juice

Min = 0; Max = 999

Frequency can be reported per month, per week or per day.

Eating habits (EAH) - Question identifier:EAH_Q10B

In the past 30 days, how many times did you drink the following beverages?

Per month, per week or per day

Frequency can be reported per month, per week or per day.

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

Eating habits (EAH) - Question identifier:EAH_Q15A

In the past 30 days, how many times did you drink the following beverages?

Fruit flavoured drinks or sports drinks

Min = 0; Max = 999

e.g., FruitéTM, fruit punch, GatoradeTM

Frequency can be reported per month, per week or per day.

Eating habits (EAH) - Question identifier:EAH_Q15B

In the past 30 days, how many times did you drink the following beverages?

Per month, per week or per day

Frequency can be reported per month, per week or per day.

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

Eating habits (EAH) - Question identifier:EAH_Q20A

In the past 30 days, how many times did you drink the following beverages?

Regular soft drinks

Min = 0; Max = 999

Exclude diet soft drinks.

Frequency can be reported per month, per week or per day.

Eating habits (EAH) - Question identifier:EAH_Q20B

In the past 30 days, how many times did you drink the following beverages?

Per month, per week or per day

Frequency can be reported per month, per week or per day.

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

Eating habits (EAH) - Question identifier:EAH_Q25A

In the past 30 days, how many times did you drink the following beverages?

Sweetened coffee drinks or iced tea

Min = 0; Max = 999

e.g., StarbucksTM Macchiato, Tim Hortons Iced CappTM, NesteaTM

Frequency can be reported per month, per week or per day.

Eating habits (EAH) - Question identifier:EAH_Q25B

In the past 30 days, how many times did you drink the following beverages?

Per month, per week or per day

Frequency can be reported per month, per week or per day.

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

Eating habits (EAH) - Question identifier:EAH_Q30A

In the past 30 days, how many times did you drink the following beverages?

Energy drinks

Min = 0; Max = 999

e.g., Red BullTM, MonsterTM

Frequency can be reported per month, per week or per day.

Eating habits (EAH) - Question identifier:EAH_Q30B

In the past 30 days, how many times did you drink the following beverages?

Per month, per week or per day

Frequency can be reported per month, per week or per day.

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

Eating habits (EAH) - Question identifier:EAH_Q35A

In the past 30 days, how many times did you drink the following beverages?

Chocolate milk

Min = 0; Max = 999

Frequency can be reported per month, per week or per day.

Eating habits (EAH) - Question identifier:EAH_Q35B

In the past 30 days, how many times did you drink the following beverages?

Per month, per week or per day

Frequency can be reported per month, per week or per day.

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

Eating habits (EAH) - Question identifier:EAH_Q40A

In the past 30 days, how many times did you eat the following fruits and vegetables?

Fruits

Min = 0; Max = 999

Frequency can be reported per month, per week or per day.

Include fresh, frozen, canned or dried.
Exclude fruit juices.

Eating habits (EAH) - Question identifier:EAH_Q40B

In the past 30 days, how many times did you eat the following fruits and vegetables?

Per month, per week or per day

Include fresh, frozen, canned or dried.

Frequency can be reported per month, per week or per day.

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

Eating habits (EAH) - Question identifier:EAH_Q45A

In the past 30 days, how many times did you eat the following fruits and vegetables?

Dark green vegetables

Min = 0; Max = 999

e.g., broccoli, green beans, dark lettuce, spinach

Include fresh, frozen, canned or dried.

Frequency can be reported per month, per week or per day.

Eating habits (EAH) - Question identifier:EAH_Q45B

In the past 30 days, how many times did you eat the following fruits and vegetables?

Per month, per week or per day

Include fresh, frozen, canned or dried.

Frequency can be reported per month, per week or per day.

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

Eating habits (EAH) - Question identifier:EAH_Q50A

In the past 30 days, how many times did you eat the following fruits and vegetables?

Orange-coloured vegetables

Min = 0; Max = 999

e.g., carrots, orange bell peppers, sweet potatoes

Include fresh, frozen, canned or dried.

Frequency can be reported per month, per week or per day.

Eating habits (EAH) - Question identifier:EAH_Q50B

In the past 30 days, how many times did you eat the following fruits and vegetables?

Per month, per week or per day

Include fresh, frozen, canned or dried.

Frequency can be reported per month, per week or per day.

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

Eating habits (EAH) - Question identifier:EAH_Q55A

In the past 30 days, how many times did you eat the following fruits and vegetables?

Starchy vegetables

Min = 0; Max = 999

e.g., white potatoes, corn

Exclude deep fried potatoes.
Include fresh, frozen, canned or dried.

Frequency can be reported per month, per week or per day.

Eating habits (EAH) - Question identifier:EAH_Q55B

In the past 30 days, how many times did you eat the following fruits and vegetables?

Per month, per week or per day

Include fresh, frozen, canned or dried.

Frequency can be reported per month, per week or per day.

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

Eating habits (EAH) - Question identifier:EAH_Q60A

In the past 30 days, how many times did you eat the following fruits and vegetables?

Other vegetables

Min = 0; Max = 999

e.g., cucumber, celery, cabbage, tomatoes, cauliflower

Include fresh, frozen, canned or dried.

Frequency can be reported per month, per week or per day.

Eating habits (EAH) - Question identifier:EAH_Q60B

In the past 30 days, how many times did you eat the following fruits and vegetables?

Per month, per week or per day

Include fresh, frozen, canned or dried.

Frequency can be reported per month, per week or per day.

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

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

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

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

• 1: Yes
• 2: No

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

What did you use the information for?

Would you say:

Please consider everyone in your household when selecting your responses.

Select all that apply.

• 1: To choose foods
• 2: To determine how much to eat every day
• 3: To plan meals or to help with grocery shopping
• 4: To assess how well you are eating
• 5: Other

Sleep quality (SLE) - Question identifier:SLE_R01

The next questions are about your sleep.

Sleep quality (SLE) - Question identifier:SLE_R01B

First, we want to know details about your sleep in the past 7 days.

Sleep quality (SLE) - Question identifier:SLE_Q01A

On weekdays, at what time did you usually fall asleep?
Hour

• 01: 1
• 02: 2
• 03: 3
• 04: 4
• 05: 5
• 06: 6
• 07: 7
• 08: 8
• 09: 9
• 10: 10
• 11: 11
• 12: 12

Sleep quality (SLE) - Question identifier:SLE_Q01B

On weekdays, at what time did you usually fall asleep?
Minutes

• 00: 0
• 05: 5
• 10: 10
• 15: 15
• 20: 20
• 25: 25
• 30: 30
• 35: 35
• 40: 40
• 45: 45
• 50: 50
• 55: 55

Sleep quality (SLE) - Question identifier:SLE_Q01C

On weekdays, at what time did you usually fall asleep?
a.m. or p.m.

• 1: a.m
• 2: p.m

Sleep quality (SLE) - Question identifier:SLE_Q02A

On weekdays, at what time did you usually wake up?
Hour

• 01: 1
• 02: 2
• 03: 3
• 04: 4
• 05: 5
• 06: 6
• 07: 7
• 08: 8
• 09: 9
• 10: 10
• 11: 11
• 12: 12

Sleep quality (SLE) - Question identifier:SLE_Q02B

On weekdays, at what time did you usually wake up?
Minutes

• 00: 0
• 05: 5
• 10: 10
• 15: 15
• 20: 20
• 25: 25
• 30: 30
• 35: 35
• 40: 40
• 45: 45
• 50: 50
• 55: 55

Sleep quality (SLE) - Question identifier:SLE_Q02C

On weekdays, at what time did you usually wake up?
a.m. or p.m.

• 1: a.m
• 2: p.m

Sleep quality (SLE) - Question identifier:SLE_Q03A

On weekend days, at what time did you usually fall asleep?
Hour

• 01: 1
• 02: 2
• 03: 3
• 04: 4
• 05: 5
• 06: 6
• 07: 7
• 08: 8
• 09: 9
• 10: 10
• 11: 11
• 12: 12

Sleep quality (SLE) - Question identifier:SLE_Q03B

On weekend days, at what time did you usually fall asleep?
Minutes

• 00: 0
• 05: 5
• 10: 10
• 15: 15
• 20: 20
• 25: 25
• 30: 30
• 35: 35
• 40: 40
• 45: 45
• 50: 50
• 55: 55

Sleep quality (SLE) - Question identifier:SLE_Q03C

On weekend days, at what time did you usually fall asleep?
a.m. or p.m.

• 1: a.m
• 2: p.m

Sleep quality (SLE) - Question identifier:SLE_Q04A

On weekend days, at what time did you usually wake up?
Hour

• 01: 1
• 02: 2
• 03: 3
• 04: 4
• 05: 5
• 06: 6
• 07: 7
• 08: 8
• 09: 9
• 10: 10
• 11: 11
• 12: 12

Sleep quality (SLE) - Question identifier:SLE_Q04B

On weekend days, at what time did you usually wake up?
Minutes

• 00: 0
• 05: 5
• 10: 10
• 15: 15
• 20: 20
• 25: 25
• 30: 30
• 35: 35
• 40: 40
• 45: 45
• 50: 50
• 55: 55

Sleep quality (SLE) - Question identifier:SLE_Q04C

On weekend days, at what time did you usually wake up?
a.m. or p.m.

• 1: a.m
• 2: p.m

Sleep quality (SLE) - Question identifier:SLE_Q15

Overall, how would you rate your sleep quality over the past 7 days?

• 1: Excellent
• 2: Good
• 3: Fair
• 4: Poor

Sleep quality (SLE) - Question identifier:SLE_Q45

In the past 7 days, on how many days did you wake up 3 or more times during your sleep?

Number of days

• 0: 0
• 1: 1
• 2: 2
• 3: 3
• 4: 4
• 5: 5
• 6: 6
• 7: 7

Injury and poisoning (IAP) - Question identifier:IAP_Q05

The next questions are about injuries or poisonings which occurred in the past 12 months and were serious enough to limit your normal activities whether at home, at work, or at leisure, after the injury or poisoning occurred.
In the past 12 months, did you have any injuries or poisonings?

Exclude repetitive strain injuries and chronic back pain.

Exclude food poisoning, poison ivy, allergies and skin inflammations caused by an allergic reaction.

• 1: Yes
• 2: No

Injury and poisoning (IAP) - Question identifier:IAP_Q10

In the past 12 months, how many times did you experience injuries or poisonings?

Min = 1; Max = 30

Exclude repetitive strain injuries and chronic back pain.

Exclude food poisoning, poison ivy, allergies and skin inflammations caused by an allergic reaction.

Injury and poisoning (IAP) - Question identifier:IAP_Q15

In the past 12 months, what types of injuries or poisonings did you have?

Was it:

Exclude repetitive strain injuries and chronic back pain.

Exclude food poisoning, poison ivy, allergies and skin inflammations caused by an allergic reaction.


Select all that apply.

• 01: Head injury (Include concussions and other traumatic brain injuries, skull, or facial fracture.
  Exclude superficial head injuries such as a cut or scrape.)
• 02: Broken or fractured bones (Exclude skull or facial fracture.)
• 03: Burn, scald or chemical burn
• 04: Dislocation
• 05: Sprain or strain (e.g., torn ligaments or muscles, back strain)
• 06: Cut, puncture, animal or human bite
• 07: Scrape, bruise or blister
• 08: Poisoning (e.g., poisoning by pharmaceuticals, illicit drugs, and chemicals, including pesticides, heavy metals, gases or vapors, and common household substances, such as bleach and ammonia)
• 09: Injury to internal organs
• 10: Other

Injury and poisoning (IAP) - Question identifier:IAP_Q20

In the past 12 months, how many times did you have head injuries?

Min = 1; Max = 30

Include concussions and other traumatic brain injuries, skull, or facial fracture.

Exclude superficial head injuries such as a cut or scrape.

Injury and poisoning (IAP) - Question identifier:IAP_R30

The next questions refer to the most serious head injury that occurred in the past 12 months.

Injury and poisoning (IAP) - Question identifier:IAP_Q30

What were you doing when your most serious head injury occurred?

Include concussions and other traumatic brain injuries, skull, or facial fracture.

Exclude superficial head injuries such as a cut or scrape.

• 01: Riding a bike
• 02: Riding or driving a motor vehicle (Include off-road vehicles.)
• 03: Doing sports or recreational activity (Exclude riding a bike, riding or driving a motor vehicle.)
• 04: Doing household chores, outdoor yard maintenance or unpaid work
• 05: Working at a paid job or business (Exclude when driving is your job, and you were were injured while driving.)
• 06: Walking
• 07: Going up or down stairs
• 08: Being assaulted or victimized
• 10: Other

Injury and poisoning (IAP) - Question identifier:IAP_Q35

Did you consult a health professional for this head injury?

Include concussions and other traumatic brain injuries, skull, or facial fracture.

Exclude superficial head injuries such as a cut or scrape.

• 1: Yes
• 2: No

Injury and poisoning (IAP) - Question identifier:IAP_Q40

When did you initially consult the health professional?

Was it:

• 1: The same day
• 2: The next day
• 3: 2 to 3 days after the injury
• 4: 4 to 6 days after the injury
• 5: A week or more after the injury

Injury and poisoning (IAP) - Question identifier:IAP_Q45

Where did you initially consult the health professional?

Was it:

• 01: Where the injury happened or on-site medical or paramedical care (e.g., school, university, workplace, residence
  Exclude first aid offered by non-health professionals such as colleagues, parents, teachers.)
• 02: Hospital emergency room
• 03: Hospital outpatient clinic (e.g., day surgery, treatment services, diagnostic tests)
• 04: Doctor's office or clinic (e.g., family doctor or general practitioner's office, walk-in clinic, sports medicine clinic)
• 05: Other health care provider's office (e.g., chiropractor, physiotherapist, occupational therapist)
• 06: Community health centre [or CLSC] (Include nursing stations.)
• 07: Home care
• 08: Virtual care including telephone health lines (e.g., Health Links, Health 811)
• 09: Other

Injury and poisoning (IAP) - Question identifier:IAP_Q50

Have you received follow-up care from any health professional for this head injury?

Include ongoing care.

• 1: Yes
• 2: No

Injury and poisoning (IAP) - Question identifier:IAP_Q55

Where are you currently receiving, or where have you received follow-up care from a health professional for this head injury from a health professional?

Was it:

Select all that apply.

• 01: Hospital emergency room
• 02: Hospital outpatient clinic (e.g., day surgery, treatment services, diagnostic tests)
• 03: Doctor's office or clinic (e.g., family doctor or general practitioner's office, walk-in clinic, sports medicine clinic)
• 04: Other healthcare provider's office (e.g., chiropractor, physiotherapist, occupational therapist)
• 05: Community health centre [or CLSC] (Include nursing stations.)
• 06: Rehabilitation centre
• 07: Home care
• 08: Virtual care including telephone health lines (e.g., Health Links, Health 811)
• 09: Other

Injury and poisoning (IAP) - Question identifier:IAP_R65

Now some questions about falls that you may have experienced in the past 12 months.

Injury and poisoning (IAP) - Question identifier:IAP_Q65

In the past 12 months, did you have any falls

Include events where you came into contact with the floor or other lower surface, such as falling from heights, losing balance, stumbling, mis-stepping, or collapsing.

Select Yes even if you did not sustain an injury from the fall, and your normal activities, whether at home, at work, or at leisure, were not limited.

• 1: Yes
• 2: No

Injury and poisoning (IAP) - Question identifier:IAP_Q70

In the past 12 months, how many times have you fallen?

Would you say:

• 1: Once
• 2: Twice
• 3: Three times or more

Injury and poisoning (IAP) - Question identifier:IAP_Q75

In the past 12 months, what have been your injuries due to a fall?

Was it:

Select all that apply.

• 01: Sprain or strain
• 02: Bruise
• 03: Cut
• 04: Hip fracture
• 05: Leg or ankle fracture
• 06: Arm or wrist fracture
• 07: Spinal fracture
• 08: Head injury (Include concussions and other traumatic brain injuries, skull, or facial fracture.
  
  Exclude superficial head injuries such as a cut or scrape.)
• 09: Other
• 10: No injuries

Injury and poisoning (IAP) - Question identifier:IAP_Q80

In the past 12 months, which injury was the most serious among the injuries you had due to a fall?

Was it:

The most serious injury was the one that imposed the greatest restriction on normal activities.

• 01: Sprain or strain
• 02: Bruise
• 03: Cut
• 04: Hip fracture
• 05: Leg or ankle fracture
• 06: Arm or wrist fracture
• 07: Spinal fracture
• 08: Head injury (Include concussions and other traumatic brain injuries, skull, or facial fracture.
  
  Exclude superficial head injuries such as a cut or scrape.)
• 09: Other

Injury and poisoning (IAP) - Question identifier:IAP_R85

The next questions refer to the fall where you had your most serious injury within the past 12 months.

Injury and poisoning (IAP) - Question identifier:IAP_R86

The next questions refer to your last fall within the past 12 months.

Injury and poisoning (IAP) - Question identifier:IAP_Q90

When did this fall happen?

Was it:

• 1: Winter
• 2: Spring
• 3: Summer
• 4: Fall

Injury and poisoning (IAP) - Question identifier:IAP_Q95

Which option best describes how this fall happened?

Was it:

• 01: Slipped, tripped, or stumbled while walking on ice or snow
• 02: Slipped, tripped, or stumbled while walking on any surface other than ice or snow
• 03: While doing a sport or physical exercise (Exclude walking.)
• 04: While going up or down stairs or steps
• 05: While reaching for something
• 06: While rising from furniture (e.g., bed, chair)
• 07: While stepping in or out of the bathtub or standing in bathtub
• 08: From elevated position (e.g., ladder, tree, roof)
• 09: Due to health problems (e.g., fainting, weakness, dizziness, hip or knee gave out, seizure)
• 10: Other

Injury and poisoning (IAP) - Question identifier:IAP_Q100

Where did this fall happen?

• 1: Inside your home
• 2: Outside your home, but inside a building, facility, or worksite
• 3: Outdoors

Injury and poisoning (IAP) - Question identifier:IAP_Q105

Were ^YOU using an assistive device at the time of this fall?

e.g., walker, wheelchair, cane, leg brace or grab bar

• 1: Yes
• 2: No

Injury and poisoning (IAP) - Question identifier:IAP_Q110

Did you consult a health professional for the injury resulting from this fall?

• 1: Yes
• 2: No

Injury and poisoning (IAP) - Question identifier:IAP_Q115

Where did you initially consult the health professional?

• 01: Where the injury happened or on-site medical or paramedical care (e.g., school, university, workplace, residence
  Exclude first aid offered by non-health professionals such as colleagues, parents, teachers.)
• 02: Hospital emergency room
• 03: Hospital outpatient clinic (e.g., day surgery, treatment services, diagnostic tests)
• 04: Doctor's office or clinic (e.g., family doctor or general practitioner's office, walk-in clinic, sports medicine clinic)
• 05: Other health care provider's office (e.g., chiropractor, physiotherapist, occupational therapist)
• 06: Community health centre [or CLSC] (Include nursing stations.)
• 07: Home care
• 08: Virtual care including telephone health lines (e.g., Health Links, Health 811)
• 09: Other

Injury and poisoning (IAP) - Question identifier:IAP_Q120

Have you received follow-up care from any health professional for the injury resulting from this fall?

Include ongoing care.

• 1: Yes
• 2: No

Injury and poisoning (IAP) - Question identifier:IAP_Q125

Where are you currently receiving, or where have you received follow-up care from a health professional for the injury resulting from this fall?

Select all that apply.

• 01: Hospital emergency room
• 02: Hospital outpatient clinic (e.g., day surgery, treatment services, diagnostic tests)
• 03: Doctor's office or clinic (e.g., family doctor or general practitioner's office, walk-in clinic, sports medicine clinic)
• 04: Other healthcare provider's office (e.g., chiropractor, physiotherapist, occupational therapist)
• 05: Community health centre [or CLSC] (Include nursing stations.)
• 06: Rehabilitation centre
• 07: Home care
• 08: Virtual care including telephone health lines (e.g., Health Links, Health 811)
• 09: Other

Injury and poisoning (IAP) - Question identifier:IAP_Q130

Are you worried or concerned that in the future you might fall?

• 1: Yes
• 2: No

Injury and poisoning (IAP) - Question identifier:IAP_Q135

As a result of this concern, have you discontinued any activities you used to do or enjoyed?

• 1: Yes
• 2: No

Use of protective equipment (UPE) - Question identifier:UPE_Q05

In the past 12 months, have you participated in any of these activities?

Select all that apply.

• 1: Bicycling
• 2: In-line skating or rollerblading
• 3: Downhill skiing
• 4: Snowboarding
• 5: Skateboarding
• 6: Playing ice hockey

Use of protective equipment (UPE) - Question identifier:UPE_Q10

When riding a bicycle, how often do you wear a helmet?

• 1: Always
• 2: Most of the time
• 3: Rarely
• 4: Never

Use of protective equipment (UPE) - Question identifier:UPE_Q20

When in-line skating or rollerblading, how often do you wear the following equipment?
A helmet

• 1: Always
• 2: Most of the time
• 3: Rarely
• 4: Never

Use of protective equipment (UPE) - Question identifier:UPE_Q25

When in-line skating or rollerblading, how often do you wear the following equipment?
Wrist guards or wrist protectors

• 1: Always
• 2: Most of the time
• 3: Rarely
• 4: Never

Use of protective equipment (UPE) - Question identifier:UPE_Q30

When in-line skating or rollerblading, how often do you wear the following equipment?
Elbow pads

• 1: Always
• 2: Most of the time
• 3: Rarely
• 4: Never

Use of protective equipment (UPE) - Question identifier:UPE_Q35

When in-line skating or rollerblading, how often do you wear the following equipment?
Knee pads

• 1: Always
• 2: Most of the time
• 3: Rarely
• 4: Never

Use of protective equipment (UPE) - Question identifier:UPE_Q45

When downhill skiing, how often do you wear a helmet?

• 1: Always
• 2: Most of the time
• 3: Rarely
• 4: Never

Use of protective equipment (UPE) - Question identifier:UPE_Q50

When snowboarding, how often do you wear the following equipment?
A helmet

• 1: Always
• 2: Most of the time
• 3: Rarely
• 4: Never

Use of protective equipment (UPE) - Question identifier:UPE_Q55

When snowboarding, how often do you wear the following equipment?
Wrist guards or wrist protectors

• 1: Always
• 2: Most of the time
• 3: Rarely
• 4: Never

Use of protective equipment (UPE) - Question identifier:UPE_Q65

When skateboarding, how often do you wear the following equipment?
A helmet

• 1: Always
• 2: Most of the time
• 3: Rarely
• 4: Never

Use of protective equipment (UPE) - Question identifier:UPE_Q70

When skateboarding, how often do you wear the following equipment?
Wrist guards or wrist protectors

• 1: Always
• 2: Most of the time
• 3: Rarely
• 4: Never

Use of protective equipment (UPE) - Question identifier:UPE_Q75

When skateboarding, how often do you wear the following equipment?
Elbow pads

• 1: Always
• 2: Most of the time
• 3: Rarely
• 4: Never

Use of protective equipment (UPE) - Question identifier:UPE_Q85

When playing ice hockey, how often do you wear a mouth guard?

• 1: Always
• 2: Most of the time
• 3: Rarely
• 4: Never

Current smoking status (CSS) - Question identifier:CSS_R01

The next questions are about cigarette smoking.

Current smoking status (CSS) - Question identifier:CSS_Q05

Have you ever smoked a whole cigarette?

Include cigarettes that are self-made. Exclude e-cigarettes or vapes.

• 1: Yes
• 2: No

Current smoking status (CSS) - Question identifier:CSS_Q10

How old were you when you smoked your first whole cigarette?

Min = 0; Max = 999

Current smoking status (CSS) - Question identifier:CSS_Q15

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

• 1: Yes
• 2: No

Current smoking status (CSS) - Question identifier:CSS_Q20

In the past 30 days, how often did you smoke cigarettes?

• 1: Every day
• 2: Less than once a day, but at least once a week
• 3: Less than once a week, but at least once in the past month
• 4: Not at all

Current smoking status (CSS) - Question identifier:CSS_Q25

How many cigarettes do you usually smoke each day?

Min = 0; Max = 999

Current smoking status (CSS) - Question identifier:CSS_Q35

In the past 30 days, how many days have you smoked one or more cigarettes?

Min = 0; Max = 99

Current smoking status (CSS) - Question identifier:CSS_Q30

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

Min = 0; Max = 999

Current smoking status (CSS) - Question identifier:CSS_Q41

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

• 1: Yes
• 2: No

Smoking - past use (SPU) - Question identifier:SPU_Q05

Have you ever smoked cigarettes daily?

• 1: Yes
• 2: No

Smoking - past use (SPU) - Question identifier:SPU_Q10

When did you stop smoking?

• 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

Smoking - past use (SPU) - Question identifier:SPU_Q15

At what age did you begin to smoke cigarettes daily?

Min = 0; Max = 999

Smoking - past use (SPU) - Question identifier:SPU_Q20

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

Min = 0; Max = 999

Smoking - past use (SPU) - Question identifier:SPU_Q25

When did you stop smoking daily?

• 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

Smoking - past use (SPU) - Question identifier:SPU_Q30

Was that when you completely quit smoking?

• 1: Yes
• 2: No

Smoking - past use (SPU) - Question identifier:SPU_Q35

When did you stop completely?

• 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

Smoking - past use (SPU) - Question identifier:SPU_Q40

During the past 12 months, did you do any of the following to help you quit smoking?

Select all that apply.

• 01: Use nicotine replacement products (e.g., nicotine patch, nicotine gum, nicotine inhaler, nicotine nasal spray, nicotine lozenge, nicotine mouth spray)
• 02: Use a tobacco-free nicotine pouch (These products are sometimes called 'white pouches', e.g. Zonnic®, Zyn®, On!®, Dryft®, Lyft®, Skruf®. These products do not contain tobacco; they are smokeless and spit-free.)
• 03: Use smoking cessation medications (e.g., Zyban®, Wellbutrin® or Champix®)
• 04: Use an internet-based program or an app
• 05: Use a vaping device or e-cigarette
• 06: Make a deal with a friend or your family
• 07: Reduce the number of cigarettes
• 08: Try to quit smoking on your own
• 09: Other

Smoking - past use (SPU) - Question identifier:SPU_Q45

During the past 12 months, did you do any of the following to help you when you quit smoking completely?

Select all that apply.

• 01: Use nicotine replacement products (e.g., nicotine patch, nicotine gum, nicotine inhaler, nicotine nasal spray, nicotine lozenge, nicotine mouth spray)
• 02: Use a tobacco-free nicotine pouch (These products are sometimes called 'white pouches', e.g. Zonnic®, Zyn®, On!®, Dryft®, Lyft®, Skruf®. These products do not contain tobacco; they are smokeless and spit-free.)
• 03: Use smoking cessation medications (e.g., Zyban®, Wellbutrin® or Champix®)
• 04: Use an internet-based program or an app
• 05: Use a vaping device or e-cigarette
• 06: Make a deal with a friend or your family
• 07: Reduce the number of cigarettes
• 08: Try to quit smoking on your own
• 09: Other

Smoking - stages of change 2 (SCH2) - Question identifier:SCH2_Q005

Are you seriously considering quitting smoking within the next 6 months?

• 1: Yes
• 2: No

Electronic cigarettes and vaping (ECV) - Question identifier:ECV_R05

Now some questions about electronic cigarettes (e-cigarettes) or vaping devices.

Electronic cigarettes and vaping (ECV) - Question identifier:ECV_Q05

Have you ever tried an e-cigarette or vaping device, also known as a vape?

Include vaping e-liquid with nicotine and without nicotine i.e., just flavouring

Exclude vaping cannabis.

• 1: Yes
• 2: No

Electronic cigarettes and vaping (ECV) - Question identifier:ECV_Q10

At what age did you first use an e-cigarette or vaping device, also known as a vape?

Min = 0; Max = 999

Electronic cigarettes and vaping (ECV) - Question identifier:ECV_Q15

In the past 30 days, how often did you use an e-cigarette or vaping device, also known as vape?

Would you say:

• 1: Every day
• 2: Almost every day
• 3: At least once a week
• 4: At least once in the past month
• 5: Not at all

Electronic cigarettes and vaping (ECV) - Question identifier:ECV_Q21

The last time you used an e-cigarette or vaping device, also known as a vape, what did it contain?

Was it:

• 1: An e-cigarette or a vaping device with nicotine
• 2: An e-cigarette or a vaping device without nicotine (e.g., just flavouring)
• 3: An e-cigarette or a vaping device but you did not know what it contained

Electronic cigarettes and vaping (ECV) - Question identifier:ECV_Q25A

During the past 30 days, on how many days did you vape an e-cigarette or a vaping device with nicotine?

Min = 0; Max = 30

Electronic cigarettes and vaping (ECV) - Question identifier:ECV_Q25B

During the past 30 days, on how many days did you vape an e-cigarette or a vaping device without nicotine?

Min = 0; Max = 30

e.g., just flavouring

Electronic cigarettes and vaping (ECV) - Question identifier:ECV_Q25C

During the past 30 days, on how many days did you vape an e-cigarette or a vaping device but you did not know what it contained?

Min = 0; Max = 30

Electronic cigarettes and vaping (ECV) - Question identifier:ECV_Q22

In the past 30 days, which one of these flavours did you use most often?

Was it:

• 01: Tobacco
• 02: Fruit
• 03: Candy
• 04: Dessert
• 05: Mint or menthol
• 06: Coffee or tea
• 07: Alcohol
• 08: Flavourless
• 09: No usual flavour
• 10: Other

Electronic cigarettes and vaping (ECV) - Question identifier:ECV_Q30

Which did you try first, an e-cigarette or vaping device or a cigarette?

• 1: E-cigarette or vaping device
• 2: Cigarette

Cannabis use (CAN) - Question identifier:CAN_R05

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_Q05

Have you ever used or tried cannabis?

• 1: Yes
• 2: No

Cannabis use (CAN) - Question identifier:CAN_Q05A

Have you used or tried cannabis just once or more than once?

• 1: Just once
• 2: More than once

Cannabis use (CAN) - Question identifier:CAN_Q05B

At what age did you first try cannabis?

Min = 0; Max = 999

Cannabis use (CAN) - Question identifier:CAN_Q05C

Have you used cannabis in the past 12 months?

• 1: Yes
• 2: No

Cannabis use (CAN) - Question identifier:CAN_Q10

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

Report the average use in the last 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

Cannabis use (CAN) - Question identifier:CAN_Q15

In the past 12 months, which of the following methods did you use to consume cannabis?

Would you say:

Select all that apply.

• 1: Smoked (e.g., joint, pipe, bong)
• 2: Vaporized
• 3: Swallowed (e.g., in food, beverages, capsules)
• 4: Absorbed (e.g., placed under the tongue, applied to skin)
• 5: Other method — specify:

Cannabis use (CAN) - Question identifier:CAN_Q20

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

Would you say:

• 1: Smoked
• 2: Vaporized
• 3: Swallowed
• 4: Absorbed
• 5: Other method

Cannabis use (CAN) - Question identifier:CAN_Q25

In the past 12 months, which of the following cannabis products have you used?

Would you say:

Select all that apply.

• 01: Dried flower or leaf
• 02: Hashish (e.g., hash, hash oil)
• 03: Cannabis oil for oral use (e.g., capsules, spray, tincture)
• 04: Cannabis vape pens or cartridges
• 05: Cannabis concentrates (e.g., shatter, budder, butane honey oil)
• 06: Cannabis edible food products (e.g., baked goods, candy, other foods)
• 07: Cannabis beverages (e.g., cola, tea, coffee)
• 08: Topicals (e.g., lotion, ointment, creams applied to skin)
• 09: Other product — specify:

Cannabis use (CAN) - Question identifier:CAN_Q30

In the past 12 months, for which of the following purposes have you used cannabis?

Would you say:

• 1: Non-medical purposes only
• 2: Medical purposes only (Either with or without a medical document)
• 3: Both medical and non-medical purposes

Cannabis use (CAN) - Question identifier:CAN_Q35

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

Would you say:

Select all that apply.

• 01: Pain
• 02: Nausea or vomiting
• 03: Lack of appetite or weight loss
• 04: Headaches or migraines
• 05: Muscle spasms or seizures
• 06: Anxiety or depression
• 07: Symptoms of PTSD
• 08: Problems sleeping
• 09: Opioid withdrawal symptoms
• 10: Other symptom — specify:

Cannabis use (CAN) - Question identifier:CAN_Q40

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

• 1: Yes
• 2: No

Cannabis use (CAN) - Question identifier:CAN_Q45

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

Would you say:

• 1: Never
• 2: 1 day
• 3: 2 or 3 days
• 4: 1 or 2 days per week
• 5: 3 or 4 days per week
• 6: 5 or 6 days per week
• 7: Daily

Cannabis use (CAN) - Question identifier:CAN_Q50

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

Min = 0; Max = 999

Cannabis use (CAN) - Question identifier:CAN_Q55

In the past 12 months, have you experienced any adverse or negative health effects from using cannabis?

Would you say:

Select all that apply.

• 01: Nausea or vomiting
• 02: Heart or blood pressure problems
• 03: Feeling faint or dizzy or passing out
• 04: Panic reactions
• 05: Hallucinations or psychosis
• 06: Flashbacks
• 07: Depression
• 08: Dissociation or depersonalization (Feeling detached or disconnected from yourself or those around you)
• 09: Lung or breathing problems
• 10: Other
• 11: Or No adverse or negative health effects experienced from using cannabis

Cannabis use (CAN) - Question identifier:CAN_Q60

In the past 12 months, did you seek medical help for any adverse or negative health effects caused by using cannabis?

• 1: Yes
• 2: No

Cannabis use (CAN) - Question identifier:CAN_Q65

Where did you seek medical help

Include both in-person and virtual consultations such as over the telephone, by video, or written correspondence.

Was it:

Select all that apply.

• 01: A poison center
• 02: A family doctor or other health care provider's office
• 03: A walk-in clinic
• 04: A community health centre [or CLSC] (Include nursing stations)
• 05: A telephone health service or helpline (e.g., Health Links, Health Connect Ontario, Health811, Health-Line, TeleCare, Info-Santé)
• 06: Addiction support services
• 07: A hospital emergency room
• 08: Other

Alcohol use (ALC) - Question identifier:ALC_R01

Now some questions about alcohol consumption.

Alcohol use (ALC) - Question identifier:ALC_Q05

Have you ever had a drink in your lifetime?

[A "drink" refers to:
- a small bottle, draft or can of beer, cider or cooler
- a glass of wine
- a cocktail or glass containing 1.5 ounces of liquor.]

• 1: Yes
• 2: No

Alcohol use (ALC) - Question identifier:ALC_Q10

In the past 12 months, have you had a drink of beer, wine, liquor or any other alcoholic beverage?

• 1: Yes
• 2: No

Alcohol use (ALC) - Question identifier:ALC_Q15

In 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 5 times a week
• 7: Daily or almost daily

Alcohol use (ALC) - Question identifier:ALC_Q20

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

Alcohol use during the past week (ALW) - Question identifier:ALW_Q05

In the past 7 days, that is from ^7DAYSAGO to yesterday, did you have a drink of beer, wine, liquor or any other alcoholic beverage?

• 1: Yes
• 2: No

Alcohol use during the past week (ALW) - Question identifier:ALW_Q10

In the past 7 days, that is from ^7DAYSAGO to yesterday, how many drinks did you have each day?
a. #{YESTERDAY.DayOfWeek("En", "TRUE")}, #{YESTERDAY}

Number of drinks per day

• 00: 0
• 01: 1
• 02: 2
• 03: 3
• 04: 4
• 05: 5
• 06: 6
• 07: 7
• 08: 8
• 09: 9
• 10: 10
• 11: 11
• 12: 12
• 13: 13
• 14: 14
• 15: 15
• 16: 16
• 17: 17
• 18: 18
• 19: 19
• 20: 20
• 21: 21
• 22: 22
• 23: 23
• 24: 24
• 25: 25
• 26: 26
• 27: 27
• 28: 28
• 29: 29
• 30: 30
• 31: 31
• 32: 32
• 33: 33
• 34: 34
• 35: 35
• 36: 36
• 37: 37
• 38: 38
• 39: 39
• 40: 40
• 41: 41
• 42: 42
• 43: 43
• 44: 44
• 45: 45
• 46: 46
• 47: 47
• 48: 48
• 49: 49
• 50: 50 or more

Alcohol use during the past week (ALW) - Question identifier:ALW_Q15

In the past 7 days, that is from ^7DAYSAGO to yesterday, how many drinks did you have each day?
b. #{2DAYSAGO.DayOfWeek("En", "TRUE")}, #{2DAYSAGO}

• 00: 0
• 01: 1
• 02: 2
• 03: 3
• 04: 4
• 05: 5
• 06: 6
• 07: 7
• 08: 8
• 09: 9
• 10: 10
• 11: 11
• 12: 12
• 13: 13
• 14: 14
• 15: 15
• 16: 16
• 17: 17
• 18: 18
• 19: 19
• 20: 20
• 21: 21
• 22: 22
• 23: 23
• 24: 24
• 25: 25
• 26: 26
• 27: 27
• 28: 28
• 29: 29
• 30: 30
• 31: 31
• 32: 32
• 33: 33
• 34: 34
• 35: 35
• 36: 36
• 37: 37
• 38: 38
• 39: 39
• 40: 40
• 41: 41
• 42: 42
• 43: 43
• 44: 44
• 45: 45
• 46: 46
• 47: 47
• 48: 48
• 49: 49
• 50: 50 or more

Alcohol use during the past week (ALW) - Question identifier:ALW_Q20

In the past 7 days, that is from ^7DAYSAGO to yesterday, how many drinks did you have each day?
c. #{3DAYSAGO.DayOfWeek("En", "TRUE")}, #{3DAYSAGO}

• 00: 0
• 01: 1
• 02: 2
• 03: 3
• 04: 4
• 05: 5
• 06: 6
• 07: 7
• 08: 8
• 09: 9
• 10: 10
• 11: 11
• 12: 12
• 13: 13
• 14: 14
• 15: 15
• 16: 16
• 17: 17
• 18: 18
• 19: 19
• 20: 20
• 21: 21
• 22: 22
• 23: 23
• 24: 24
• 25: 25
• 26: 26
• 27: 27
• 28: 28
• 29: 29
• 30: 30
• 31: 31
• 32: 32
• 33: 33
• 34: 34
• 35: 35
• 36: 36
• 37: 37
• 38: 38
• 39: 39
• 40: 40
• 41: 41
• 42: 42
• 43: 43
• 44: 44
• 45: 45
• 46: 46
• 47: 47
• 48: 48
• 49: 49
• 50: 50 or more

Alcohol use during the past week (ALW) - Question identifier:ALW_Q25

In the past 7 days, that is from ^7DAYSAGO to yesterday, how many drinks did you have each day?
d. #{4DAYSAGO.DayOfWeek("En", "TRUE")}, #{4DAYSAGO}

• 00: 0
• 01: 1
• 02: 2
• 03: 3
• 04: 4
• 05: 5
• 06: 6
• 07: 7
• 08: 8
• 09: 9
• 10: 10
• 11: 11
• 12: 12
• 13: 13
• 14: 14
• 15: 15
• 16: 16
• 17: 17
• 18: 18
• 19: 19
• 20: 20
• 21: 21
• 22: 22
• 23: 23
• 24: 24
• 25: 25
• 26: 26
• 27: 27
• 28: 28
• 29: 29
• 30: 30
• 31: 31
• 32: 32
• 33: 33
• 34: 34
• 35: 35
• 36: 36
• 37: 37
• 38: 38
• 39: 39
• 40: 40
• 41: 41
• 42: 42
• 43: 43
• 44: 44
• 45: 45
• 46: 46
• 47: 47
• 48: 48
• 49: 49
• 50: 50 or more

Alcohol use during the past week (ALW) - Question identifier:ALW_Q30

In the past 7 days, that is from ^7DAYSAGO to yesterday, how many drinks did you have each day?
e. #{5DAYSAGO.DayOfWeek("En", "TRUE")}, #{5DAYSAGO}

• 00: 0
• 01: 1
• 02: 2
• 03: 3
• 04: 4
• 05: 5
• 06: 6
• 07: 7
• 08: 8
• 09: 9
• 10: 10
• 11: 11
• 12: 12
• 13: 13
• 14: 14
• 15: 15
• 16: 16
• 17: 17
• 18: 18
• 19: 19
• 20: 20
• 21: 21
• 22: 22
• 23: 23
• 24: 24
• 25: 25
• 26: 26
• 27: 27
• 28: 28
• 29: 29
• 30: 30
• 31: 31
• 32: 32
• 33: 33
• 34: 34
• 35: 35
• 36: 36
• 37: 37
• 38: 38
• 39: 39
• 40: 40
• 41: 41
• 42: 42
• 43: 43
• 44: 44
• 45: 45
• 46: 46
• 47: 47
• 48: 48
• 49: 49
• 50: 50 or more

Alcohol use during the past week (ALW) - Question identifier:ALW_Q35

In the past 7 days, that is from ^7DAYSAGO to yesterday, how many drinks did you have each day?
f. #{6DAYSAGO.DayOfWeek("En", "TRUE")}, #{6DAYSAGO}

• 00: 0
• 01: 1
• 02: 2
• 03: 3
• 04: 4
• 05: 5
• 06: 6
• 07: 7
• 08: 8
• 09: 9
• 10: 10
• 11: 11
• 12: 12
• 13: 13
• 14: 14
• 15: 15
• 16: 16
• 17: 17
• 18: 18
• 19: 19
• 20: 20
• 21: 21
• 22: 22
• 23: 23
• 24: 24
• 25: 25
• 26: 26
• 27: 27
• 28: 28
• 29: 29
• 30: 30
• 31: 31
• 32: 32
• 33: 33
• 34: 34
• 35: 35
• 36: 36
• 37: 37
• 38: 38
• 39: 39
• 40: 40
• 41: 41
• 42: 42
• 43: 43
• 44: 44
• 45: 45
• 46: 46
• 47: 47
• 48: 48
• 49: 49
• 50: 50 or more

Alcohol use during the past week (ALW) - Question identifier:ALW_Q40

In the past 7 days, that is from ^7DAYSAGO to yesterday, how many drinks did you have each day?
g. #{7DAYSAGO.DayOfWeek("En", "TRUE")}, #{7DAYSAGO}

• 00: 0
• 01: 1
• 02: 2
• 03: 3
• 04: 4
• 05: 5
• 06: 6
• 07: 7
• 08: 8
• 09: 9
• 10: 10
• 11: 11
• 12: 12
• 13: 13
• 14: 14
• 15: 15
• 16: 16
• 17: 17
• 18: 18
• 19: 19
• 20: 20
• 21: 21
• 22: 22
• 23: 23
• 24: 24
• 25: 25
• 26: 26
• 27: 27
• 28: 28
• 29: 29
• 30: 30
• 31: 31
• 32: 32
• 33: 33
• 34: 34
• 35: 35
• 36: 36
• 37: 37
• 38: 38
• 39: 39
• 40: 40
• 41: 41
• 42: 42
• 43: 43
• 44: 44
• 45: 45
• 46: 46
• 47: 47
• 48: 48
• 49: 49
• 50: 50 or more

Parental experiences (PAX) - Question identifier:PAX_Q05

Is there a child living in this household who is 5 years old or younger?

Would you say:

• 1: Yes, there is one child who meets this definition
• 2: Yes, there is more than one child who meets this definition (e.g., twins, or there is more than one child five years or younger in the household)
• 3: No, there are no children who meet this definition

Parental experiences (PAX) - Question identifier:PAX_Q10A

What is this child's first name?

Long Answer Length = 30

Parental experiences (PAX) - Question identifier:PAX_Q10B

What is the last-born child's first name?

Long Answer Length = 30

Refer to the last baby born between ^DV_5YEARSAGO and ^THISDATE

Parental experiences (PAX) - Question identifier:PAX_Q15C

What is [baby's name]'s date of birth?
Year

• 01: 2025
• 02: 2024
• 03: 2023
• 04: 2022
• 05: 2021
• 06: 2020
• 07: 2019
• 08: 2018

Parental experiences (PAX) - Question identifier:PAX_Q15B

What is [baby's name]'s date of birth?
Month

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

Parental experiences (PAX) - Question identifier:PAX_Q15A

What is [baby's name]'s date of birth?
Day

Min = 1; Max = 31

Parental experiences (PAX) - Question identifier:PAX_Q20

Was [baby's name] a single birth or a multiple birth?

• 1: Single birth
• 2: Multiple births (e.g., twins)

Parental experiences (PAX) - Question identifier:PAX_R25

The next questions are specific to [baby's name].

Parental experiences (PAX) - Question identifier:PAX_Q25

Did you give birth to to [baby's name] ?

• 1: Yes
• 2: No

Parental experiences (PAX) - Question identifier:PAX_Q30

During the three months before your pregnancy with [baby's name] , did you take a vitamin supplement containing folic acid?

Include prenatal vitamins, multivitamins, or single supplements.

• 1: Yes
• 2: No
• 3: Don't know

Parental experiences (PAX) - Question identifier:PAX_Q35

During the first trimester or the first three months of your pregnancy with [baby's name] , did you take a vitamin supplement containing folic acid?

Include prenatal vitamins, multivitamins, or single supplements.

• 1: Yes
• 2: No
• 3: Don't know

Parental experiences (PAX) - Question identifier:PAX_Q40

During your pregnancy with [baby's name] , did you take a vitamin or mineral supplement containing iron?

Include prenatal vitamins, multivitamins, or single supplements.

Exclude intravenous (IV) iron infusion.

• 1: Yes
• 2: No
• 3: Don't know

Parental experiences (PAX) - Question identifier:PAX_Q45A

Just before your pregnancy with [baby's name] , how much did you weigh?
Weight

Min = 0; Max = 999

Parental experiences (PAX) - Question identifier:PAX_Q45B

Just before your pregnancy with [baby's name] , how much did you weigh?
Pounds or kilograms

• 1: Pounds
• 2: Kilograms

Parental experiences (PAX) - Question identifier:PAX_Q50A

How much weight did you gain during that pregnancy?
Weight gained

Min = -999; Max = 999

If you lost weight, enter a negative value.

Parental experiences (PAX) - Question identifier:PAX_Q50B

How much weight did you gain during that pregnancy?
Pounds or kilograms

If you lost weight, enter a negative value.

• 1: Pounds
• 2: Kilograms

Parental experiences (PAX) - Question identifier:PAX_Q55

Did anyone regularly smoke in your presence during your pregnancy with [baby's name] ?

• 1: Yes
• 2: No

Parental experiences (PAX) - Question identifier:PAX_Q60

Are you [baby's name] 's parent or one of the main people responsible for their care?

e.g., biological, non-biological, adoptive, and step parents or guardians

• 1: Yes
• 2: No

Parental experiences (PAX) - Question identifier:PAX_R70

.

Parental experiences (PAX) - Question identifier:PAX_Q70

Was [baby's name] ever breastfed or given any amount of breast milk even for a short time?

Include colostrum, expressed breast milk and breast milk from a donor or donor milk bank.

• 1: Yes
• 2: No

Parental experiences (PAX) - Question identifier:PAX_Q75

What is the main reason that [baby's name] was not breastfed or given breast milk?

Would you say:

• 01: Formula feeding was easier
• 02: Formula was as good as breast milk
• 03: Breastfeeding was unappealing
• 04: Medical condition - mother
• 05: Not enough support or information to breastfeed
• 06: Return to work or school
• 07: Previously unsuccessful experience with breastfeeding
• 08: Other

Parental experiences (PAX) - Question identifier:PAX_Q80

Is [baby's name] still breastfeeding or being given breast milk?

Include colostrum, expressed breast milk and breast milk from a donor or donor milk bank.

• 1: Yes
• 2: No

Parental experiences (PAX) - Question identifier:PAX_Q85A

How old was [baby's name] when they stopped breastfeeding or receiving breast milk?

Age

Min = 0; Max = 72

You can report the age in days, weeks, months or years

Parental experiences (PAX) - Question identifier:PAX_Q85B

How old was [baby's name] when they stopped breastfeeding or receiving breast milk?

Time period

You can report the age in days, weeks, months or years.

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

Parental experiences (PAX) - Question identifier:PAX_Q90

What is the main reason that [baby's name] stopped receiving breast milk?

Would you say:

• 01: Not enough breast milk
• 02: Inconvenience / fatigue due to breastfeeding
• 03: Difficulty with breastfeeding
• 04: Medical condition - mother
• 05: Medical condition - baby
• 06: Planned to stop at this time
• 07: Child weaned themselves
• 08: Returned to work or school
• 09: Not enough support or inforamtion to breastfeed
• 10: Other

Parental experiences (PAX) - Question identifier:PAX_Q95

[Is [baby's name] receiving]/['When [baby's name] was less than a year old, did they receive]/['When [baby's name] was less than one year old and fed breast milk, did they receive]/[When [baby's name] was fed breast milk, did they receive] a vitamin D supplement?

Would you say:

• 1: Every day or almost every day
• 2: Occasionally
• 3: Never

Parental experiences (PAX) - Question identifier:PAX_Q100

Now that [baby's name] iis more than a year old, are they receiving a vitamin D supplement?

Would you say:

• 1: Every day or almost every day
• 2: Occasionally
• 3: Never

Parental experiences (PAX) - Question identifier:PAX_Q105

[Have/While still being given breast milk, had] other liquids been introduced to [baby's name]'s diet?

e.g., formula, cow's milk, soy milk, water or juice

Exclude breast milk.

Exclude any formula supplementation that only occurred during the first week after birth.

• 1: Yes
• 2: No

Parental experiences (PAX) - Question identifier:PAX_Q110

What was the first liquid introduced?

Would you say:

• 1: Formula
• 2: Cow's milk
• 3: Soy milk
• 4: Water
• 5: Juice
• 6: Other

Parental experiences (PAX) - Question identifier:PAX_Q115A

How old was [baby's name] when other liquids were first introduced?

Age

Min = 0; Max = 72

e.g., formula, cow's milk, soy milk, water or juice

Exclude breast milk.

Exclude any formula supplementation that only occurred during the first week after birth.

You can report the age in days, weeks, months or years.

Parental experiences (PAX) - Question identifier:PAX_Q115B

How old was [baby's name] when other liquids were first introduced?

Time period

e.g., formula, cow's milk, soy milk, water or juice

Exclude breast milk.

Exclude any formula supplementation that only occurred during the first week after birth.

You can report the age in days, weeks, months or years.

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

Parental experiences (PAX) - Question identifier:PAX_Q120

Have solid foods been introduced to [baby's name]'s diet?

e.g., cereals, meat, vegetables or fruits

• 1: Yes
• 2: No

Parental experiences (PAX) - Question identifier:PAX_Q125

What was the first solid food?

Would you say:

• 1: Infant cereals
• 2: Fruits or vegetables
• 3: Meat and meat alternatives (Include eggs, tofu, legumes, peas or lentils.)
• 4: Other

Parental experiences (PAX) - Question identifier:PAX_Q130A

How old was [baby's name] when solids were first added?

Age

Min = 1; Max = 72

You can report the age in days, weeks, months or years.

Parental experiences (PAX) - Question identifier:PAX_Q130B

How old was [baby's name] when solids were first added?

Time period

You can report the age in days, weeks, months or years.

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

Parental experiences (PAX) - Question identifier:PAX_Q140

[How often does [baby's name]/[When [baby's name]was less than one year old, how often did they] sleep in the same bed with you or anyone else?

Would you say:

• 1: Every day or almost every day
• 2: Occasionally
• 3: Never

Parental experiences (PAX) - Question identifier:PAX_Q145

When [baby's name] was less than 4 months, how often did they sleep in the same bed with you or anyone else?

Would you say:

• 1: Every day or almost every day
• 2: Occasionally
• 3: Never

Maternal experiences - alcohol use during pregnancy (MXA) - Question identifier:MXA_Q05

In the 3 months before your pregnancy with [baby's name], or before you realized you were pregnant, did you drink alcohol?

• 1: Yes
• 2: No

Maternal experiences - alcohol use during pregnancy (MXA) - Question identifier:MXA_Q10

How often did you drink?

• 1: A few times a month or less
• 2: Once or twice a week
• 3: Many times a week
• 4: Everyday

Maternal experiences - alcohol use during pregnancy (MXA) - Question identifier:MXA_Q12

On the days you did drink, how many drinks did you usually have?

• 1: One drink
• 2: Two drinks
• 3: Three drinks
• 4: More than three drinks

Maternal experiences - alcohol use during pregnancy (MXA) - Question identifier:MXA_Q15

Once you found out you were pregnant with [baby's name] , did you drink alcohol?

• 1: Yes
• 2: No

Maternal experiences - alcohol use during pregnancy (MXA) - Question identifier:MXA_Q20

How often did you drink?

• 1: A few times a month or less
• 2: Once or twice a week
• 3: Many times a week
• 4: Everyday

Maternal experiences - alcohol use during pregnancy (MXA) - Question identifier:MXA_Q22

On the days you did drink, how many drinks did you usually have?

• 1: One drink
• 2: Two drinks
• 3: Three drinks
• 4: More than three drinks

Maternal experiences - alcohol use during pregnancy (MXA) - Question identifier:MXA_Q35

[While you were still breastfeeding [baby's name], did]/[Since giving birth to [baby's name], do] you drink alcohol?

• 1: Yes
• 2: No

Maternal experiences - alcohol use during pregnancy (MXA) - Question identifier:MXA_Q40

How often [did/do] you drink?

• 1: A few times a month or less
• 2: Once or twice a week
• 3: Many times a week
• 4: Everyday

Maternal experiences - alcohol use during pregnancy (MXA) - Question identifier:MXA_Q42

On the days you [did/do] drink, how many drinks [did/do] you usually have?

• 1: One drink
• 2: Two drinks
• 3: Three drinks
• 4: More than three drinks

Maternal experiences - smoking during pregnancy (MXS) - Question identifier:MXS_Q05

In the 3 months before your pregnancy with [baby's name] , or before you realized you were pregnant, did you smoke cigarettes?

• 1: Yes
• 2: No

Maternal experiences - smoking during pregnancy (MXS) - Question identifier:MXS_Q10

How often did you smoke?

• 1: Everyday
• 2: Almost everyday
• 3: A few times a week
• 4: Rarely

Maternal experiences - smoking during pregnancy (MXS) - Question identifier:MXS_Q15

Once you found out you were pregnant with [baby's name] , did you smoke?

• 1: Yes
• 2: No

Maternal experiences - smoking during pregnancy (MXS) - Question identifier:MXS_Q20

How often did you smoke?

• 1: Everyday
• 2: Almost everyday
• 3: A few times a week
• 4: Rarely

Pap smear test (PAP) - Question identifier:PAP_R005

Now some questions about the Pap smear test.

Pap smear test (PAP) - Question identifier:PAP_Q005

Have you ever had a Pap smear test?

• 1: Yes
• 2: No

Pap smear test (PAP) - Question identifier:PAP_Q010

When was the last time?

Would you say:

• 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

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?

Would you say:

Select all that apply.

• 01: Lack of time
• 02: Did not think it was necessary
• 03: Health care provider did not think it was necessary, never brought it up
• 04: Feelings of fear or discomfort
• 05: Don't have a health care provider
• 06: [Had a complete hysterectomy]
• 07: Did not know it existed or that it was a possibility
• 08: Had an HPV Test instead
• 09: Other

Pap smear test (PAP) - Question identifier:PAP_Q020

How often do you usually have this test?

Would you say:

• 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

Pap smear test (PAP) - Question identifier:PAP_Q025

High-risk types of Human papillomavirus (HPV) cause changes in the cells of the cervix that can be detected on a Pap test as abnormal changes. The HPV test is an additional tool used to show presence of high-risk type of HPV.

This test is not a Pap test but is collected in a similar way. An HPV test could be done at the same time as a Pap test or instead of a Pap test. It can be administered by your health care provider or by self-sampling at home.


Have you ever had an HPV test?

• 1: Yes
• 2: No
• 3: Don't know

Mammography (MAM) - Question identifier:MAM_Q005

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

A person with a high-risk status based on a family or medical history could have a mammogram at an earlier age than the general guidelines stipulated by their province or territory.

• 1: Yes
• 2: No

Mammography (MAM) - Question identifier:MAM_Q010

When was the last time?

Would you say:

• 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

Mammography (MAM) - Question identifier:MAM_Q015

What were the reasons for having this mammogram?

Would you say:

Select all that apply.

• 01: Family history of breast cancer
• 02: Part of 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

Mammography (MAM) - Question identifier:MAM_Q020

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

Would you say:

Select all that apply.

• 1: Lack of time
• 2: Did not think it was necessary
• 3: Health care provider did not think it was necessary, never brought it up
• 4: Feelings of fear or discomfort
• 5: Don't have a health care provider
• 6: Had a bilateral mastectomy (i.e., both breasts were removed)
• 7: Other

Mammography (MAM) - Question identifier:MAM_Q025

How often do you usually have this test?

Would you say:

• 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

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 or a small stool sample is collected and placed inside a tube.

Have you ever had this test?

The fecal test is also called gFOBT or FIT. gFOBT stands for "Guaiac-based Fecal Occult Blood Test". FIT stands for "Fecal Immunochemical Test".

• 1: Yes
• 2: No

Colorectal cancer testing (CCT) - Question identifier:CCT_Q010

When was the last time?

Would you say:

• 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

Colorectal cancer testing (CCT) - Question identifier:CCT_Q015

What are the reasons you did not have a fecal test [in the past 2 years]?

Would you say:

Select all that apply.

• 01: Lack of time
• 02: No access to test (e.g.,distance, clinic hours or cost)
• 03: Did not think it was necessary
• 04: Health care provider did not think it was necessary, never brought it up
• 05: Feelings of fear or discomfort
• 06: Don't have a health care provider
• 07: Had a colonoscopy or sigmoidoscopy instead
• 08: Did not know it existed or that it was a possibility
• 09: Other

Colorectal cancer testing (CCT) - Question identifier:CCT_Q020

How often do you usually have this fecal test?

Would you say:

• 1: It was the first time
• 2: More than once a year
• 3: Every year
• 4: Every 2 years
• 5: Less than every 2 years
• 6: No fixed frequency

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?

The sigmoidoscopy can be performed by a nurse or non-specialist physician. The colonoscopy preparation requires fasting and drinking a large quantity of liquid to empty the colon.

• 1: Yes
• 2: No

Colorectal cancer testing (CCT) - Question identifier:CCT_Q030

What are the reasons you have not had these tests?

Would you say:

Select all that apply.

• 01: Lack of time
• 02: No access to test (e.g.,distance, clinic hours or cost)
• 03: Did not think it was necessary
• 04: Health care provider did not think it was necessary, never brought it up
• 05: Feelings of fear or discomfort
• 06: Don't have a health care provider
• 07: Had a fecal test instead
• 08: Did not know it existed or that it was a possibility
• 09: Other

Colorectal cancer testing (CCT) - Question identifier:CCT_Q035

Which of these tests have you had [a colonoscopy, a sigmoidoscopy or both]?

Would you say:

• 1: Colonoscopy (Examines the entire colon.)
• 2: Sigmoidoscopy (Examines the first section of the colon and requires less preparation.)
• 3: Both

Colorectal cancer testing (CCT) - Question identifier:CCT_Q040

When was the last time you had a sigmoidoscopy?

Would you say:

• 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

Colorectal cancer testing (CCT) - Question identifier:CCT_Q045

What are the reasons you have not had this test in the past 10 years?

Would you say:

Select all that apply.

• 01: Lack of time
• 02: No access to test (e.g.,distance, clinic hours or cost)
• 03: Did not think it was necessary
• 04: Health care provider did not think it was necessary, never brought it up
• 05: Feelings of fear or discomfort
• 06: Don't have a health care provider
• 07: Had a different colorectal test instead
• 08: Did not know it existed or that it was a possibility
• 09: Other

Colorectal cancer testing (CCT) - Question identifier:CCT_Q050

How often do you usually have this test?

Would you say:

• 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

Colorectal cancer testing (CCT) - Question identifier:CCT_Q055

When was the last time you had a colonoscopy?

Would you say:

• 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

Colorectal cancer testing (CCT) - Question identifier:CCT_Q065

What are the reasons you have not had this test in the past 10 years?

Would you say:

Select all that apply.

• 01: Lack of time
• 02: No access to test (e.g.,distance, clinic hours or cost)
• 03: Did not think it was necessary
• 04: Health care provider did not think it was necessary, never brought it up
• 05: Feelings of fear or discomfort
• 06: Don't have a health care provider
• 07: Had a different colorectal test instead
• 08: Did not know it existed or that it was a possibility
• 09: Other

Colorectal cancer testing (CCT) - Question identifier:CCT_Q070

How often do you usually have this test?

Would you say:

• 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

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

Colorectal cancer testing (CCT) - Question identifier:CCT_Q080

Were you prescribed [a colonscopy/a sigmoidoscopy/one of these tests] because of a family history of colorectal cancer, an inflammatory bowel disease, a colorectal cancer follow up or symptoms of colorectal cancer

e.g., you previously had colorectal cancer or polyps, have a history of colorectal cancer in at least one first degree blood relative, have an inflammatory bowel disease, have other symptoms indicating a predisposition to colorectal cancer.

• 1: Yes
• 2: No

Flu shots (FLU) - Question identifier:FLU_R01

Now a few questions about the flu vaccine.

Flu shots (FLU) - Question identifier:FLU_Q05

In the past 12 months, have you had a seasonal flu vaccine?

Seasonal flu vaccine can be administered either by a needle, called a flu shot, or by a nasal spray called FluMist®

• 1: Yes
• 2: No

Flu shots (FLU) - Question identifier:FLU_Q10

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

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

Flu shots (FLU) - Question identifier:FLU_Q15

Was that this year or last year?

• 1: This year
• 2: Last year

Flu shots (FLU) - Question identifier:FLU_Q20

What are the reasons that you did not have a seasonal flu vaccine in the past 12 months?

Select all that apply.

• 1: Did not think it was necessary
• 2: Concern about discomfort or side effects
• 3: Flu is not that severe
• 4: Flu vaccine does not work that well
• 5: Previously had a bad reaction to the flu vaccine or other vaccine
• 6: Other

Vaccines (VAC) - Question identifier:VAC_Q05

Excluding COVID-19 and flu vaccines, how likely are you to receive a vaccine if it is recommended to you by a health care provider?

E.g.: routine or travel vaccines or vaccines for high-risk populations

• 1: Very likely
• 2: Somewhat likely
• 3: Somewhat unlikely
• 4: Very unlikely

Regular health care provider 2 (RHC2) - Question identifier:RHC2_R05

Now, here are some questions about primary health care. This type of health care is often delivered by family doctors or nurse practitioners.

Regular health care provider 2 (RHC2) - Question identifier:RHC2_Q05

Do you have a regular health care provider? By this, we mean a primary health professional that you can consult with when you need care or advice for your health.

Select "Yes, another health professional" if you receive regular care from locums.

• 1: Yes, a family doctor
• 2: Yes, a nurse practitioner
• 3: Yes, another health professional — specify:
• 4: No

Regular health care provider 2 (RHC2) - Question identifier:RHC2_Q10

When you consult with ['this family doctor/this nurse practitioner/this other health professional], do you have to pay out-of-pocket for your consultation because they work in a private pay model?

Exclude any fees associated with medical notes for work or school, expedited blood work, prescription renewals, cosmetic procedures, travel medicine advice and vaccines, tests requested by employers or insurance companies, and other services that are not covered by the universal health care system.

• 1: Yes
• 2: No
• 3: Don't know

Regular health care provider 2 (RHC2) - Question identifier:RHC2_R20

Some patients receive primary health care from a team of health professionals working together to provide coordinated services and care. In addition to family doctors and nurses, these teams could include social workers, dieticians and pharmacists, but do not include medical specialists (e.g., cardiologists, oncologists).

Regular health care provider 2 (RHC2) - Question identifier:RHC2_Q20

Are you a patient of a team of health professionals that work together to provide you with coordinated services and care?

Exclude care provided by teams of medical specialists (e.g., cardiologists, oncologists).

Depending on where you live, these teams might be called a Family Health Team, Family Medicine Group, Integrated Care Network or Primary Care Network.

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

Regular health care provider 2 (RHC2) - Question identifier:RHC2_Q25

Do you have to pay out-of-pocket for any of the services provided by the team of health professionals?

Exclude any fees associated with medical notes for work or school, expedited blood work, prescription renewals, cosmetic procedures, travel medicine advice and vaccines, tests requested by employers or insurance companies, and other services that are not covered by the universal health care system.

• 1: Yes
• 2: No
• 3: Don't know

Regular health care provider 2 (RHC2) - Question identifier:RHC2_Q30

Why do you not have a regular health care provider?

Would you say:

Select all that apply.

• 01: Currently on a waitlist
• 02: Do not need one in particular
• 03: No one in the area is taking new patients
• 04: There are no health care providers in the area
• 05: You have not tried to find one
• 06: You had one who left, retired, or changed their practice
• 07: You moved to a new area
• 08: You aged out of paediatric care (Paediatric care is health care for children and youth)
• 09: Other

Regular health care provider 2 (RHC2) - Question identifier:RHC2_R45

The following questions are about consultations you may have had in the past 12 months with a primary health care provider when you were sick or concerned about your health.

Regular health care provider 2 (RHC2) - Question identifier:RHC2_Q45

In the past 12 months, did you consult a primary health care provider when you were sick or concerned about your health?

Exclude visits to the emergency department, scheduled check-ups or routine testing, and consultations with optometrists, dentists or medical specialists (e.g., cardiologists, oncologists).

Include both in-person and virtual consultations, such as over the telephone, by video, or by written correspondence.

• 1: Yes
• 2: No

Regular health care provider 2 (RHC2) - Question identifier:RHC2_Q50

Thinking about the most recent consultation when you were sick or concerned about your health, was this consultation with your [family doctor/nurse practitioner/other health professional who is your regular health care provider]?

Exclude consultations with medical specialists (e.g., cardiologists, oncologists).

Include both in-person and virtual consultations, such as over the telephone, by video, or by written correspondence

• 1: Yes
• 2: No

Regular health care provider 2 (RHC2) - Question identifier:RHC2_Q51

Thinking about the most recent consultation when you were sick or concerned about your health, was this consultation with a member of the team of health professionals who provide you with coordinated services or care?

Exclude consultations with medical specialists (e.g., cardiologists, oncologists).

Include both in-person and virtual consultations, such as over the telephone, by video, or by written correspondence.

• 1: Yes
• 2: No

Regular health care provider 2 (RHC2) - Question identifier:RHC2_Q55

Thinking about the most recent consultation when you were sick or concerned about your health, did you have to pay out-of-pocket because this primary health care provider works in a private pay model?

Exclude any fees associated with medical notes for work or school, expedited blood work, prescription renewals, cosmetic procedures, travel medicine advice and vaccines, tests requested by employers or insurance companies, and other services that are not covered by the universal health care system.

• 1: Yes
• 2: No
• 3: Don't know

Regular health care provider 2 (RHC2) - Question identifier:RHC2_Q60

Still thinking about this most recent consultation, how long did you have to wait between the time you requested care and when you consulted [this primary health care provider/your family doctor/nurse practitioner/your other health professional who is your regular health care provider/a member from your team of health professionals]?

Would you say:

• 01: The same day
• 02: The next day
• 03: 2 to 3 days
• 04: 4 to 6 days
• 05: 1 week to less than 2 weeks
• 06: 2 weeks to less than 1 month
• 07: 1 month to less than 3 months
• 08: 3 months to less than 6 months
• 09: 6 months or more

Regular health care provider 2 (RHC2) - Question identifier:RHC2_Q65

Still thinking about this most recent consultation, how satisfied were you with the time you had to wait between requesting care and when you consulted with [this primary health care provider/your family doctor/nurse practitioner/your other health professional who is your regular health care provider/a member from your team of health professionals]?

Would you say:

• 1: Very satisfied
• 2: Satisfied
• 3: Neither satisfied nor dissatisfied
• 4: Dissatisfied
• 5: Very dissatisfied

Regular health care provider 2 (RHC2) - Question identifier:RHC2_Q70

Still thinking about this most recent consultation, indicate to what extent you agree or disagree with the following statement.

I received health care that was sensitive to my cultural background and identity from [this primary heatlth care provider/[my family doctor/my nurse practitioner/my other health professional who is my regular health care provider/the member of my team of health professionals].

Would you say:

This is health care that makes the patient feel they are respected, safe and can trust the health care provider.

Include how you were treated based on age, sex, gender, sexual orientation, ethnicity, indigenous identity, race, language, accent, religion or spirituality, disability, or other factors.

• 1: Strongly agree
• 2: Agree
• 3: Neither agree nor disagree
• 4: Disagree
• 5: Strongly disagree

Regular health care provider 2 (RHC2) - Question identifier:RHC2_Q70A

For which reasons do you feel you did not receive health care that was sensitive to your cultural background and identity?

Would you say:

Select all that apply.

• 01: Your ethnicity or culture
• 02: Your Indigenous identity
• 03: Your race or skin colour
• 04: Your language
• 05: Your accent
• 06: Your religion or spirituality
• 07: Your age
• 08: Your sex (Refers to sex assigned at birth.)
• 09: Your gender (Refers to an individual's personal and social identity as a man, woman, or non-binary person.)
• 10: Your sexual orientation (refers to how a person describes their sexuality.)
• 11: A disability
• 12: Other
• 13: Or Don't know

Regular health care provider 2 (RHC2) - Question identifier:RHC2_Q70B

For which reasons do you feel you did not receive health care that was sensitive to your cultural background and identity?

Would you say:

Select all that apply.

• 01: Your ethnicity or culture
• 02: Your Indigenous identity
• 03: Your race or skin colour
• 04: Your language
• 05: Your accent
• 06: Your religion or spirituality
• 07: Your age
• 08: Your sex (Refers to sex assigned at birth.)
• 09: Your gender (Refers to an individual's personal and social identity as a man, woman, or non-binary person.)
• 10: Your sexual orientation (refers to how a person describes their sexuality.)
• 11: A disability
• 12: Other
• 13: Or Don't know

Electronic health information (EHI) - Question identifier:EHI_R05

The following questions are about your use of health technology and digital health systems in general and in relation to your own health.

Health technology includes the Internet or websites, health applications, sensors, monitoring machines, computers or laptops, mobile phones or smartphones, tablets, smartwatches.

Digital health systems include online health records, health applications, private health insurance websites or applications, doctor's website, health care provider's website or prescription applications.

Electronic health information (EHI) - Question identifier:EHI_R10

Please indicate how strongly you disagree or agree with each of the following statements.

Electronic health information (EHI) - Question identifier:EHI_Q10

Technology makes me feel actively involved with my health

• 1: Strongly disagree
• 2: Disagree
• 3: Agree
• 4: Strongly agree

Electronic health information (EHI) - Question identifier:EHI_Q15

I know how to use technology to get the health information I need

• 1: Strongly disagree
• 2: Disagree
• 3: Agree
• 4: Strongly agree

Electronic health information (EHI) - Question identifier:EHI_Q20

I know how to make technology work for me

• 1: Strongly disagree
• 2: Disagree
• 3: Agree
• 4: Strongly agree

Electronic health information (EHI) - Question identifier:EHI_Q25

I use technology to find information about health

• 1: Strongly disagree
• 2: Disagree
• 3: Agree
• 4: Strongly agree

Electronic health information (EHI) - Question identifier:EHI_Q30

I can enter data into health technology systems

• 1: Strongly disagree
• 2: Disagree
• 3: Agree
• 4: Strongly agree

Electronic health information (EHI) - Question identifier:EHI_Q35

I often use technology to understand health problems

• 1: Strongly disagree
• 2: Disagree
• 3: Agree
• 4: Strongly agree

Electronic health information (EHI) - Question identifier:EHI_Q40

Technology helps me decide what health care is best for me

• 1: Strongly disagree
• 2: Disagree
• 3: Agree
• 4: Strongly agree

Electronic health information (EHI) - Question identifier:EHI_Q45

I quickly learn how to find my way around new technology

• 1: Strongly disagree
• 2: Disagree
• 3: Agree
• 4: Strongly agree

Electronic health information (EHI) - Question identifier:EHI_Q50

I find technology helps me take care of my health

• 1: Strongly disagree
• 2: Disagree
• 3: Agree
• 4: Strongly agree

Electronic health information (EHI) - Question identifier:EHI_Q55

I use technology to share information about my health

• 1: Strongly disagree
• 2: Disagree
• 3: Agree
• 4: Strongly agree

Electronic health information (EHI) - Question identifier:EHI_Q60

I find I get better services from my health professionals when I use technology

• 1: Strongly disagree
• 2: Disagree
• 3: Agree
• 4: Strongly agree

Electronic health information (EHI) - Question identifier:EHI_Q65

I use technology to organise my health information

• 1: Strongly disagree
• 2: Disagree
• 3: Agree
• 4: Strongly agree

Electronic health information (EHI) - Question identifier:EHI_Q70

Technology improves my communication with health professionals

• 1: Strongly disagree
• 2: Disagree
• 3: Agree
• 4: Strongly agree

Electronic health information (EHI) - Question identifier:EHI_Q75

I easily learn to use new health technologies

• 1: Strongly disagree
• 2: Disagree
• 3: Agree
• 4: Strongly agree

Electronic health information (EHI) - Question identifier:EHI_Q80

I find technology useful for monitoring my health

• 1: Strongly disagree
• 2: Disagree
• 3: Agree
• 4: Strongly agree

Electronic health information (EHI) - Question identifier:EHI_R85

The following questions are about whether you can access your own health information online through websites, applications or portals.

This information may be provided by health authorities, hospitals, doctors, laboratories, pharmacies or other health professionals.

Electronic health information (EHI) - Question identifier:EHI_Q85

Which of the following types of information about your health do you have access to through websites, applications, or portals?

Would you say:

Select a category even if you have access to some, but not all of this type of health information electronically.

e.g., select "Laboratory test results" if you can access some, but not all of your laboratory test results electronically.

Select all that apply.

• 01: Laboratory test results
• 02: COVID-19 vaccine records
• 03: Vaccine or immunization records other than for COVID-19
• 04: Current medications and medication history (Include requests for prescription renewals.)
• 05: Patient visit summaries
• 06: Specialist consultation notes or records
• 07: Upcoming appointments
• 08: Forms and questionnaires
• 09: Progress notes
• 10: Discharge summaries
• 11: Medical imaging reports
• 12: Other health information
• 13: Or None of the above

Mental health 2 (DEP) - Question identifier:DEP_R001

The following questions deal with problems you may have had during the last two weeks.

Mental health 2 (DEP) - Question identifier:DEP_Q005

Over the last 2 weeks, how often have you been bothered by any of the following problems?

Had little interest or pleasure in doing things

Note: Press the help button (?) for additional information, including a list of mental health resources you may wish to access should you need any support or are in crisis

• 1: Not at all
• 2: Several days
• 3: More than half the days
• 4: Nearly every day

Mental health 2 (DEP) - Question identifier:DEP_Q010

Over the last 2 weeks, how often have you been bothered by any of the following problems?

Felt down, depressed, or hopeless

Note: Press the help button (?) for additional information, including a list of mental health resources you may wish to access should you need any support or are in crisis

• 1: Not at all
• 2: Several days
• 3: More than half the days
• 4: Nearly every day

Mental health 2 (DEP) - Question identifier:DEP_Q015

Over the last 2 weeks, how often have you been bothered by any of the following problems?

Had trouble falling or staying asleep, or sleeping too much

Note: Press the help button (?) for additional information, including a list of mental health resources you may wish to access should you need any support or are in crisis

• 1: Not at all
• 2: Several days
• 3: More than half the days
• 4: Nearly every day

Mental health 2 (DEP) - Question identifier:DEP_Q020

Over the last 2 weeks, how often have you been bothered by any of the following problems?

Felt tired or having little energy

Note: Press the help button (?) for additional information, including a list of mental health resources you may wish to access should you need any support or are in crisis

• 1: Not at all
• 2: Several days
• 3: More than half the days
• 4: Nearly every day

Mental health 2 (DEP) - Question identifier:DEP_Q025

Over the last 2 weeks, how often have you been bothered by any of the following problems?

Had poor appetite or overate

Note: Press the help button (?) for additional information, including a list of mental health resources you may wish to access should you need any support or are in crisis

• 1: Not at all
• 2: Several days
• 3: More than half the days
• 4: Nearly every day

Mental health 2 (DEP) - Question identifier:DEP_Q030

Over the last 2 weeks, how often have you been bothered by any of the following problems?

Felt bad about yourself — or that you are a failure or have let yourself or your family down

Note: Press the help button (?) for additional information, including a list of mental health resources you may wish to access should you need any support or are in crisis

• 1: Not at all
• 2: Several days
• 3: More than half the days
• 4: Nearly every day

Mental health 2 (DEP) - Question identifier:DEP_Q035

Over the last 2 weeks, how often have you been bothered by any of the following problems?

Had trouble concentrating on things, such as reading the newspaper or watching television

Note: Press the help button (?) for additional information, including a list of mental health resources you may wish to access should you need any support or are in crisis

• 1: Not at all
• 2: Several days
• 3: More than half the days
• 4: Nearly every day

Mental health 2 (DEP) - Question identifier:DEP_Q040

Over the last 2 weeks, how often have you been bothered by any of the following problems?

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

Note: Press the help button (?) for additional information, including a list of mental health resources you may wish to access should you need any support or are in crisis

• 1: Not at all
• 2: Several days
• 3: More than half the days
• 4: Nearly every day

Mental health 2 (DEP) - Question identifier:DEP_Q045

Over the last 2 weeks, how often have you been bothered by any of the following problems?

Had thoughts that you would be better off dead or of hurting yourself in some way

Note: Press the help button (?) for additional information, including a list of mental health resources you may wish to access should you need any support or are in crisis

• 1: Not at all
• 2: Several days
• 3: More than half the days
• 4: Nearly every day

Mental health 2 (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

Suicide (SUI2) - Question identifier:SUI2_R001A

The next few questions are about things that may have happened to you at any time and might be hard for you to answer. Your responses are important whether or not you have had any of these experiences. Remember that all information provided is strictly confidential.

The next set of questions can be sensitive for some people. Should you need to exit this section quickly, click on the Leave page quickly button. You will be redirected to another section and will not be able to return to these questions. No one with access to your computer or device will be able to retrieve the answers you have entered in this section.

For users of assistive technology, the Leave page quickly button can be found directly underneath the level two heading and after the Previous button. If you press a help button, the Leave page quickly button will move to the top of the overlay.

Suicide (SUI2) - Question identifier:SUI2_R001B

However, if you want to save the answers you entered and finish the questionnaire later, press the Save and finish later button. When you resume your session, you will start where you left off.

Suicide (SUI2) - Question identifier:SUI2_R005

These questions ask about sad feelings and attempted suicide. Sometimes people feel so depressed about the future that they may consider attempting suicide, that is, taking some action to end their own life.

Suicide (SUI2) - Question identifier:SUI2_Q010

During the past 12 months, did you ever seriously consider attempting suicide or taking your own life?

Press the help button (?) for a list of mental health resources you may wish to access should you need any support or are in crisis

• 1: Yes
• 2: No

Suicide (SUI2) - Question identifier:SUI2_Q015

Have you ever attempted suicide or tried taking your own life?

• 1: Yes
• 2: No

Suicide (SUI2) - Question identifier:SUI2_Q020

During the past12 months, did you ever attempt suicide or try taking your own life?

• 1: Yes
• 2: No

Suicide (SUI2) - Question identifier:SUI2_Q030

Thinking of the most recent time you attempted suicide or tried taking your own life, did this result in an injury or poisoning?

• 1: Yes
• 2: No

Suicide (SUI2) - Question identifier:SUI2_Q035

Did you require medical attention?

• 1: Yes
• 2: No

Positive mental health (PMS) - Question identifier:PMS_Q05

The following questions are about how you have been feeling during the past 2 weeks.

I've been feeling optimistic about the future.

• 1: None of the time
• 2: Rarely
• 3: Some of the time
• 4: Often
• 5: All of the time

Positive mental health (PMS) - Question identifier:PMS_Q10

The following questions are about how you have been feeling during the past 2 weeks.

I've been feeling useful.

• 1: None of the time
• 2: Rarely
• 3: Some of the time
• 4: Often
• 5: All of the time

Positive mental health (PMS) - Question identifier:PMS_Q15

The following questions are about how you have been feeling during the past 2 weeks.

I've been feeling relaxed.

• 1: None of the time
• 2: Rarely
• 3: Some of the time
• 4: Often
• 5: All of the time

Positive mental health (PMS) - Question identifier:PMS_Q20

The following questions are about how you have been feeling during the past 2 weeks.

I've been feeling interested in other people.

• 1: None of the time
• 2: Rarely
• 3: Some of the time
• 4: Often
• 5: All of the time

Positive mental health (PMS) - Question identifier:PMS_Q25

The following questions are about how you have been feeling during the past 2 weeks.

I've had energy to spare.

• 1: None of the time
• 2: Rarely
• 3: Some of the time
• 4: Often
• 5: All of the time

Positive mental health (PMS) - Question identifier:PMS_Q30

The following questions are about how you have been feeling during the past 2 weeks.

I've been dealing with problems well.

• 1: None of the time
• 2: Rarely
• 3: Some of the time
• 4: Often
• 5: All of the time

Positive mental health (PMS) - Question identifier:PMS_Q35

The following questions are about how you have been feeling during the past 2 weeks.

I've been thinking clearly.

• 1: None of the time
• 2: Rarely
• 3: Some of the time
• 4: Often
• 5: All of the time

Positive mental health (PMS) - Question identifier:PMS_Q40

The following questions are about how you have been feeling during the past 2 weeks.

I've been feeling good about myself.

• 1: None of the time
• 2: Rarely
• 3: Some of the time
• 4: Often
• 5: All of the time

Positive mental health (PMS) - Question identifier:PMS_Q45

The following questions are about how you have been feeling during the past 2 weeks.

I've been feeling close to other people.

• 1: None of the time
• 2: Rarely
• 3: Some of the time
• 4: Often
• 5: All of the time

Positive mental health (PMS) - Question identifier:PMS_Q50

The following questions are about how you have been feeling during the past 2 weeks.

I've been feeling confident.

• 1: None of the time
• 2: Rarely
• 3: Some of the time
• 4: Often
• 5: All of the time

Positive mental health (PMS) - Question identifier:PMS_Q55

The following questions are about how you have been feeling during the past 2 weeks.

I've been able to make up my own mind about things.

• 1: None of the time
• 2: Rarely
• 3: Some of the time
• 4: Often
• 5: All of the time

Positive mental health (PMS) - Question identifier:PMS_Q60

The following questions are about how you have been feeling during the past 2 weeks.

I've been feeling loved.

• 1: None of the time
• 2: Rarely
• 3: Some of the time
• 4: Often
• 5: All of the time

Positive mental health (PMS) - Question identifier:PMS_Q65

The following questions are about how you have been feeling during the past 2 weeks.

I've been interested in new things.

• 1: None of the time
• 2: Rarely
• 3: Some of the time
• 4: Often
• 5: All of the time

Positive mental health (PMS) - Question identifier:PMS_Q70

The following questions are about how you have been feeling during the past 2 weeks.

I've been feeling cheerful.

• 1: None of the time
• 2: Rarely
• 3: Some of the time
• 4: Often
• 5: All of the time

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.

Social provisions (SPS) - Question identifier:SPS_Q015

Please indicate to what extent each statement describes your current relationships with other people.

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

Social provisions (SPS) - Question identifier:SPS_Q020

Please indicate to what extent each statement describes your current relationships with other people.

There is someone I could talk to about important decisions in my life.

• 1: Strongly agree
• 2: Agree
• 3: Disagree
• 4: Strongly disagree

Social provisions (SPS) - Question identifier:SPS_Q025

Please indicate to what extent each statement describes your current relationships with other people.

I have relationships where my competence and skill are recognized.

• 1: Strongly agree
• 2: Agree
• 3: Disagree
• 4: Strongly disagree

Social provisions (SPS) - Question identifier:SPS_Q035

Please indicate to what extent each statement describes your current relationships with other people.

I feel part of a group of people who share my attitudes and beliefs.

• 1: Strongly agree
• 2: Agree
• 3: Disagree
• 4: Strongly disagree

Social provisions (SPS) - Question identifier:SPS_Q050

Please indicate to what extent each statement describes your current relationships with other people.

There are people I can count on in an emergency.

• 1: Strongly agree
• 2: Agree
• 3: Disagree
• 4: Strongly disagree

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:

• 1: Excellent
• 2: Good
• 3: Fair
• 4: Poor

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:

• 1: Excellent
• 2: Good
• 3: Fair
• 4: Poor

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?

Would you say:

• 01: Work
• 02: Financial concerns
• 03: Family
• 04: School work
• 05: Time pressures / not enough time
• 06: Health
• 07: Other
• 08: None

Perceived need for care (PNC) - Question identifier:PNC_R05

The following questions deal with the different kinds of professional help you received, or thought you needed, for your emotions, mental health or use of alcohol or drugs.

Perceived need for care (PNC) - Question identifier:PNC_Q05

During the past 12 months, did you receive any form of professional help for your emotions, mental health or use of alcohol or drugs?

This could include counseling, therapy, help with interpersonal relationships, or prescription medication.

• 1: Yes
• 2: No

Perceived need for care (PNC) - Question identifier:PNC_Q06

Which type of professional help did you receive?

Was it:

Select all that apply.

• 1: Counseling or therapy
• 2: Prescription medication
• 3: Other — specify:

Perceived need for care (PNC) - Question identifier:PNC_Q10

You mentioned that you received professional help for your emotions, mental health or use of alcohol or drugs. Do you think you received all the help you needed during the past 12 months?

• 1: Yes
• 2: No

Perceived need for care (PNC) - Question identifier:PNC_Q15

Why do you think you did not receive all the help you needed during the past 12 months?

Select all that apply.

• 01: You preferred to manage yourself
• 02: You didn't know how or where to get help
• 03: You were too busy
• 04: Your job interfered
  e.g., workload, hours of work or no cooperation from supervisor
• 05: Help was not readily available
  e.g., long wait lists
• 06: Help was not available where you live
• 07: You had trouble finding or affording transportation
• 08: Help did not meet your needs
• 09: You didn't have confidence in the health care system or social services
• 10: You couldn't afford to pay
• 11: You were afraid of what others would think of you
• 12: Language or cultural barriers
• 13: Other

Perceived need for care (PNC) - Question identifier:PNC_Q20

You mentioned that you did not receive any professional help for your emotions, mental health or use of alcohol or drugs. Do you think you needed this kind of help during the past 12 months?

• 1: Yes
• 2: No

Perceived need for care (PNC) - Question identifier:PNC_Q25

Why do you think you did not receive the help you needed during the past 12 months?

Would you say:

Select all that apply.

• 01: You preferred to manage yourself
• 02: You didn't know how or where to get help
• 03: You were too busy
• 04: Your job interfered
  e.g., workload, hours of work or no cooperation from supervisor
• 05: Help was not readily available
  e.g., long wait lists
• 06: Help was not available where you live
• 07: You had trouble finding or affording transportation
• 08: Help did not meet your needs
• 09: You didn't have confidence in the health care system or social services
• 10: You couldn't afford to pay
• 11: You were afraid of what others would think of you
• 12: Language or cultural barriers
• 13: Other

Consultations about mental health (CMH) - Question identifier:CMH_R01

The following questions are about mental and emotional well-being.

Consultations about mental health (CMH) - Question identifier:CMH_Q05

In the past 12 months, have you seen or talked to a health professional about your emotional or mental health?

Include both face to face and telephone contacts.

• 1: Yes
• 2: No

Consultations about mental health (CMH) - Question identifier:CMH_Q15A

How many times in the past 12 months did you see or talk to the following health professionals about your emotional or mental health?

Family doctor or general practitioner

Min = 0; Max = 999

Consultations about mental health (CMH) - Question identifier:CMH_Q15B

How many times in the past 12 months did you see or talk to the following health professionals about your emotional or mental health?

Psychiatrist

Min = 0; Max = 999

Consultations about mental health (CMH) - Question identifier:CMH_Q15C

How many times in the past 12 months did you see or talk to the following health professionals about your emotional or mental health?

Psychologist

Min = 0; Max = 999

Consultations about mental health (CMH) - Question identifier:CMH_Q15D

How many times in the past 12 months did you see or talk to the following health professionals about your emotional or mental health?

Nurse

Min = 0; Max = 999

Consultations about mental health (CMH) - Question identifier:CMH_Q15E

How many times in the past 12 months did you see or talk to the following health professionals about your emotional or mental health?

Social worker or counsellor

Min = 0; Max = 999

Consultations about mental health (CMH) - Question identifier:CMH_Q15F

How many times in the past 12 months did you see or talk to the following health professionals about your emotional or mental health?

Other

Min = 0; Max = 999

Oral health (OHM4) - Question identifier:OHM4_R01

Now a few questions about dental care.

Oral health (OHM4) - Question identifier:OHM4_Q05

In the past 12 months, how often have you had any persistent or ongoing mouth pain?

Include pain in teeth, gums, tongue, jaw, jaw joints.

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

Oral health (OHM4) - Question identifier:OHM4_Q10

Do you have any untreated mouth problems?

Mouth problems are defined as any condition that causes pain or discomfort.
For example:
abscesses
gum issues such as pain and bleeding
jaw pain; temporomandibular joints (TMJ)
untreated cavities, fillings needing to be replaced
tooth pain
injuries
mouth sores.

Exclude braces or other orthodontic treatments.

• 1: Yes
• 2: No
• 3: Don't know

Oral health (OHM4) - Question identifier:OHM4_Q15

When was the last time you saw a dentist, denturist, dental hygienist or any other dental specialist?

Would you say:

Services may have been provided in any setting where the oral health professional is licensed to practice.

• 1: Less than one year ago
• 2: 1 year to less than 3 years ago
• 3: 3 years ago or more
• 4: Never seen an oral health professional
• 9: DK

Oral health (OHM4) - Question identifier:OHM4_R20

Now a few questions about the cost of your dental care.

Oral health (OHM4) - Question identifier:OHM4_Q20

In the past 12 months, have you avoided going to an oral health professional for your dental care due to the cost of care?

• 1: Yes
• 2: No
• 9: DK

Oral health (OHM4) - Question identifier:OHM4_Q25

In the past 12 months, were there any [other] reasons that you did not get dental care or treatment?

Select all that apply.

• 01: Did not feel it was necessary
• 02: Could not afford to pay up front for the services and wait for the reimbursement
• 03: Could not afford to pay for the cost of the services that are not covered by insurance
• 04: Indirect costs (e.g., childcare, transportation)
• 05: Service not available in your area
• 06: There was a waitlist
• 07: Oral health professional office was not open at a convenient time
• 08: Afraid or anxious or do not like receiving oral health care
• 09: Unable to take time off from work
• 10: Too busy
• 11: Expected oral health problems to go away on their own
• 12: Other reason — specify:
• 13: Or I received all the necessary dental care or treatment
• 14: Or Don't know

COVID-19 Vaccination (COVV) - Question identifier:COVV_Q005

Since the start of the COVID-19 pandemic, how many COVID-19 vaccine doses have you received (e.g., Johnson & Johnson, Moderna, Pfizer-BioNTech, AstraZeneca, Novavax)?

Include all COVID-19 primary series as well as any booster doses.

All doses of COVID-19 vaccines after the primary series are described as booster doses.

Exclude doses you are scheduled for but have not received yet.

Number of vaccine doses

• 00: 0
• 01: 1
• 02: 2
• 03: 3
• 04: 4
• 05: 5
• 06: 6
• 07: 7
• 08: 8
• 09: 9
• 10: 10
• 11: 11
• 12: 12
• 13: 13
• 14: 14
• 15: 15
• 16: 16
• 17: 17
• 18: 18
• 19: 19
• 20: 20

COVID-19 Vaccination (COVV) - Question identifier:COVV_Q010

When did you receive your most recent COVID-19 vaccine dose?

If the exact date is not known, please provide your best estimate.

Year

• 1: 2020
• 2: 2021
• 3: 2022
• 4: 2023
• 5: 2024
• 6: 2025
• 7: 2026

COVID-19 Vaccination (COVV) - Question identifier:COVV_Q015

When did you receive your most recent COVID-19 vaccine dose?

If the exact date is not known, please provide your best estimate.

Month

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

COVID-19 Vaccination (COVV) - Question identifier:COVV_Q020

If an annual booster dose for COVID-19 is recommended by the Public Health Agency of Canada or your provincial or territorial government, how likely are you to get it every year?

All doses of COVID-19 vaccines after the primary series are described as booster doses.

• 1: Very likely
• 2: Somewhat likely
• 3: Somewhat unlikely
• 4: Very unlikely

COVID-19 infections & symptoms (COVI) - Question identifier:COVI_Q005

Since the start of the COVID-19 pandemic, how many different COVID-19 infections did you think or know you had?

Include infections with a positive test result (e.g., PCR or rapid antigen test) and infections you suspected were COVID-19 because of your symptoms or recent contact with a COVID-19 case.

Number of infections

• 00: 0
• 01: 1
• 02: 2
• 03: 3
• 04: 4
• 05: 5
• 06: 6
• 07: 7
• 08: 8
• 09: 9
• 10: 10
• 11: 11
• 12: 12
• 13: 13
• 14: 14
• 15: 15
• 16: 16
• 17: 17
• 18: 18
• 19: 19
• 20: 20

COVID-19 infections & symptoms (COVI) - Question identifier:COVI_Q010A

When did you experience your [most recent] COVID-19 infection?

Year

If the exact date is not known, please provide your best estimate.

• 1: 2020
• 2: 2021
• 3: 2022
• 4: 2023
• 5: 2024
• 6: 2025
• 7: 2026

COVID-19 infections & symptoms (COVI) - Question identifier:COVI_Q010B

When did you experience your [most recent] COVID-19 infection?

Month

If the exact date is not known, please provide your best estimate.

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

COVID-19 symptoms (PCC) - Question identifier:PCC_R001

Some people may experience more than one COVID-19 infection. When answering the following questions, think about all the times you experienced COVID-19.

COVID-19 symptoms (PCC) - Question identifier:PCC_Q005A

Three or more months after you thought or knew that you had COVID-19, did you experience any symptoms that could not be explained by anything else?

Would you say:

Include symptoms from your COVID-19 infection that lasted three or more months OR symptoms that developed after recovering from COVID-19.

• 1: Three months have not passed since you thought or knew that I had COVID-19 for the first time
• 2: Yes
• 3: No

COVID-19 symptoms (PCC) - Question identifier:PCC_Q005B

Since the start of the pandemic, did you experience any new unexplained symptoms lasting two or more months?

• 1: Yes
• 2: No

COVID-19 symptoms (PCC) - Question identifier:PCC_Q010

Do you continue to experience any of these symptoms?

• 1: Yes
• 2: No

COVID-19 symptoms (PCC) - Question identifier:PCC_Q015

For approximately how many months did you experience one or more of these symptoms?

Min = 0; Max = 99

Indicate the total number of months from when you first experienced any symptom until [today/they ended]. If you are uncertain, please provide your best estimate.

COVID-19 symptoms (PCC) - Question identifier:PCC_Q020

When your symptoms [are/were] at their worst, how often [do/did] they limit your daily activities?

Would you say:

When answering, consider the combined impact of all your symptoms.

Daily activities include preparing meals, everyday household chores, getting to appointments and running errands, looking after your personal finances, personal care, basic medical care at home and moving around inside your residence.

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

COVID-19 symptoms (PCC) - Question identifier:PCC_Q025

Overall, since you started having these symptoms, how have they changed?

When answering, think about all your symptoms combined.

• 1: Improved
• 2: Worsened
• 3: Stayed the same

Post COVID-19 condition (long COVID) - self identification (PSI) - Question identifier:PSI_R005

Some people may experience persistent, recurring, or new symptoms months after they thought or knew they had COVID-19. This is called post COVID-19 condition or long COVID when symptoms continue 3 or more months after the infection and cannot be explained by anything else.

Post COVID-19 condition is not COVID-19. Symptoms can be different from those experienced during the initial infection. Post COVID-19 condition refers to the longer-term effects some people experience after their COVID-19 infection.

Post COVID-19 condition (long COVID) - self identification (PSI) - Question identifier:PSI_Q005

Since the start of the COVID-19 pandemic, did you at any time experience post COVID-19 condition also known as long COVID?

• 1: Yes
• 2: No

Post COVID-19 condition (long COVID) - self identification (PSI) - Question identifier:PSI_Q010

Since the start of the COVID-19 pandemic, has a healthcare provider ever told you that you have or might have post COVID-19 condition also known as long COVID?

• 1: Yes
• 2: No

Labour market activities (LMAM) - Question identifier:LMAM_R01

Many of the following questions concern your activities last week.

Last week is from [7 days ago] to [yesterday]..

Labour market activities (LMAM) - Question identifier:LMAM_Q01

Last week, did you work at a job or business?

Select ''Yes'' if you worked at least one hour:
• for pay (wages, salary, etc.)
• in self-employment.
Select ''No'' if you:
• were away from work for the entire week for a reason such as vacation, illness, work schedule or layoff
• did not have a job or business but were able to work.
Select ''Permanently unable to work'' if you:
• did not have a job or business because of a physical or mental health condition that prevents you from working.

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

Labour market activities (LMAM) - Question identifier:LMAM_Q02

Last week, did you have a job or business from which you were absent?

Select ''Yes'' if you:
• were away from work for the entire week for a reason such as vacation, illness, parental leave or work schedule
• were self-employed with a business, but no work was available.
Select ''No'' if you:
• did not have a job or business
• had a casual job, but no work was available.

• 1: Yes
• 2: No

Labour market activities (LMAM) - Question identifier:LMAM_Q03

What was the main reason you were absent from work last week?

• 01: Vacation
• 02: Own illness or disability
• 03: Caring for own children
• 04: Caring for elder relative (60 years of age or older)
• 05: Maternity or parental leave
• 06: Other personal or family responsibilities
• 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., 10 days on, 10 days off, employees only)
• 12: Self-employed, no work available (Self-employed only)
• 13: Seasonal business (Excluding employees)
• 14: Other

Labour market activities (LMA3) - Question identifier:LMA3_Q01

Were you an employee or self-employed?

Select ''Employee'' if you worked:
• for pay (wages, salary, tips or commissions).
Select ''Self-employed'' if you worked:
• for your own business, farm or professional practice
• as an independent contractor, painter, babysitter, etc.

• 1: Employee
• 2: Self-employed
• 3: Working in a family business without pay

Labour market activities (LMA4) - Question identifier:LMA4_Q01

What was the full name of your business?

Long Answer Length = 50

Enter the full name of the business. If there is no business name, enter the respondent's full name.

Specify the full name of your business

Labour market activities (LMA4) - Question identifier:LMA4_Q02

For whom did you work?

Long Answer Length = 50

Enter the full name of the company, business, government department or agency, or person.

Specify who you worked for

Labour market activities (LMA4) - Question identifier:LMA4_Q03

What kind of business, industry or service was this?

Long Answer Length = 80

Examples: new home construction, primary school, municipal police, wheat farm, retail shoe store, food wholesale, car parts factory, federal government

Specify the kind of business, industry or service

Labour market activities (LMA5) - Question identifier:LMA5_R01

The following questions refer to the work or occupation in which you spent most of your time.

Labour market activities (LMA5) - Question identifier:LMA5_Q01

What kind of work were you doing?

Long Answer Length = 50

Examples: legal secretary, plumber, fishing guide, wood furniture assembler, secondary school teacher, computer programmer

Specify the kind of work you were doing

Labour market activities (LMA5) - Question identifier:LMA5_Q02

What were your most important activities or duties?

Long Answer Length = 50

Examples: prepared legal documents, installed residential plumbing, guided fishing parties, made wood furniture products, taught mathematics, developed software

Specify your most important activities or duties

Labour market activities (LMA6) - Question identifier:LMA6_Q01

[Excluding overtime, on average, how many paid hours do you usually work per week?/On average, how many hours do you usually work per week?]

Min = 0; Max = 999.9

If necessary, enter a decimal value e.g., 32.5.

Labour market activities (LBF) - Question identifier:LBF_Q11

Did you have more than one job or business last week?

• 1: Yes
• 2: No

Labour market activities (LBF) - Question identifier:LBF_Q12

On average, how many hours do you usually work per week at your other job(s)?

Min = 0; Max = 999.9

If necessary, enter a decimal value e.g., 32.5.

Telework (LM) - Question identifier:LM_Q01

At the present time, in which of the following locations do you usually work as part of your main job or business?

Select all that apply.

• 1: At a fixed location outside the home
• 2: Outside the home with no fixed location (e.g., driving, door-to-door sales)
• 3: At home (Include farms and all work done at the same address as your home, but on a different part of the property)

Telework (LM) - Question identifier:LM_Q02

Last week, what proportion of your work hours did you work at home as part of your main job or business?

Include farms and all work done at the same address as your home, but on a different part of the property

• 1: All your hours at home
• 2: More than half, but not all your hours at home
• 3: One quarter to half at home
• 4: Less than a quarter at home
• 5: No hours at home

Work family balance (WLB) - Question identifier:WLB_R05

For the next questions, please rate how much you agree with the following statements about conflict between your work and family lives.

Work family balance (WLB) - Question identifier:WLB_Q05

The demands of my work interfere with my home and family life.

• 1: Strongly agree
• 2: Agree
• 3: Neither agree nor disagree
• 4: Disagree
• 5: Strongly disagree

Work family balance (WLB) - Question identifier:WLB_Q10

The amount of time my job takes up makes it difficult to fulfill family responsibilities.

• 1: Strongly agree
• 2: Agree
• 3: Neither agree nor disagree
• 4: Disagree
• 5: Strongly disagree

Work family balance (WLB) - Question identifier:WLB_Q15

Things I want to do at home do not get done because of the demands my job puts on me.

• 1: Strongly agree
• 2: Agree
• 3: Neither agree nor disagree
• 4: Disagree
• 5: Strongly disagree

Work family balance (WLB) - Question identifier:WLB_Q20

Due to work-related duties, I have to make changes to my plans for family activities.

• 1: Strongly agree
• 2: Agree
• 3: Neither agree nor disagree
• 4: Disagree
• 5: Strongly disagree

Work family balance (WLB) - Question identifier:WLB_Q25

My job produces strain that makes it difficult to fulfill family duties.

• 1: Strongly agree
• 2: Agree
• 3: Neither agree nor disagree
• 4: Disagree
• 5: Strongly disagree

Work family balance (WLB) - Question identifier:WLB_Q30

The demands of my family or partner interfere with work-related activities.

• 1: Strongly agree
• 2: Agree
• 3: Neither agree nor disagree
• 4: Disagree
• 5: Strongly disagree

Work family balance (WLB) - Question identifier:WLB_Q35

I have to put off doing things at work because of demands on my time at home.

• 1: Strongly agree
• 2: Agree
• 3: Neither agree nor disagree
• 4: Disagree
• 5: Strongly disagree

Work family balance (WLB) - Question identifier:WLB_Q40

Things I want to do at work don't get done because of the demands of my family or partner.

• 1: Strongly agree
• 2: Agree
• 3: Neither agree nor disagree
• 4: Disagree
• 5: Strongly disagree

Work family balance (WLB) - Question identifier:WLB_Q45

My home life interferes with my responsibilities at work such as getting to work on time, accomplishing daily tasks, and working.

• 1: Strongly agree
• 2: Agree
• 3: Neither agree nor disagree
• 4: Disagree
• 5: Strongly disagree

Work family balance (WLB) - Question identifier:WLB_Q50

Family-related strain interferes with my ability to perform job-related duties.

• 1: Strongly agree
• 2: Agree
• 3: Neither agree nor disagree
• 4: Disagree
• 5: Strongly disagree

Work family balance (WLB) - Question identifier:WLB_R60

For the next questions, please rate how much you agree with the following statements about the effects of your involvement in your work.

Work family balance (WLB) - Question identifier:WLB_Q60

My involvement in my work helps me to understand different viewpoints and this helps me be a better family member.

• 1: Strongly agree
• 2: Agree
• 3: Neither agree nor disagree
• 4: Disagree
• 5: Strongly disagree

Work family balance (WLB) - Question identifier:WLB_Q65

My involvement in my work puts me in a good mood and this helps me be a better family member.

• 1: Strongly agree
• 2: Agree
• 3: Neither agree nor disagree
• 4: Disagree
• 5: Strongly disagree

Work family balance (WLB) - Question identifier:WLB_Q70

My involvement in my work helps me feel personally fulfilled and this helps me be a better family member.

• 1: Strongly agree
• 2: Agree
• 3: Neither agree nor disagree
• 4: Disagree
• 5: Strongly disagree

Work family balance (WLB) - Question identifier:WLB_R75

For the next questions, please rate how much you agree with the following statements about the effects of your involvement with your family.

Work family balance (WLB) - Question identifier:WLB_Q75

My involvement in my family helps me acquire skills and this helps me be a better worker.

• 1: Strongly agree
• 2: Agree
• 3: Neither agree nor disagree
• 4: Disagree
• 5: Strongly disagree

Work family balance (WLB) - Question identifier:WLB_Q80

My involvement in my family puts me in a good mood and this helps me be a better worker.

• 1: Strongly agree
• 2: Agree
• 3: Neither agree nor disagree
• 4: Disagree
• 5: Strongly disagree

Work family balance (WLB) - Question identifier:WLB_Q85

My involvement in my family encourages me to use my work time in a focused manner and this helps me be a better worker.

• 1: Strongly agree
• 2: Agree
• 3: Neither agree nor disagree
• 4: Disagree
• 5: Strongly disagree

Place of birth, immigration and citizenship (IM) - Question identifier:IM_Q01A

Where were you born?

Specify place of birth according to present boundaries.

• 1: Born in Canada
• 2: Born outside Canada

Place of birth, immigration and citizenship (IM) - Question identifier:IM_Q01AA

Specify the province or territory

• 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

Place of birth, immigration and citizenship (IM) - Question identifier:IM_Q01AB

Select the country

To search for a country, type the first few letters to narrow down the choices.
Note: If the country is not listed, select "Other".

• 1: Search
• 2: Other - Specify

Place of birth, immigration and citizenship (IM) - Question identifier:IM_Q02

In what year did you first come to Canada to live?

Min = 0; Max = 9999

If exact year is not known, enter best estimate.

Place of birth, immigration and citizenship (IM) - Question identifier:IM_Q03

Are you now, or have you ever been a landed immigrant?

A 'landed immigrant' (permanent resident) is a person who has been granted the right to live in Canada permanently by immigration authorities.

• 1: Yes
• 2: No

Place of birth, immigration and citizenship (IM) - Question identifier:IM_Q04

In what year did you first become a landed immigrant?

Min = 0; Max = 9999

If exact year is not known, enter best estimate.

Place of birth, immigration and citizenship (IM) - Question identifier:IM_Q05

Of what country are you a citizen?

Are you a citizen of:

Select all that apply.

• 1: Canada
• 2: Another country

Place of birth, immigration and citizenship (IM) - Question identifier:IM_Q05AA

Is it:

• 1: By birth
• 2: By naturalization (i.e., the process by which an immigrant is granted citizenship of Canada, under the Citizenship Act.)

Place of birth, immigration and citizenship (IM) - Question identifier:IM_Q05AB

Select the country

To search for a country, type the first few letters to narrow down the choices.
Note: If the country is not listed, select "Other".

• 1: Search
• 2: Other - Specify

Indigenous identity (ABM) - Question identifier:ABM_Q01

Are you First Nations, Métis or Inuk (Inuit)?

First Nations (North American Indian) includes Status and Non-Status Indians.
If "Yes", select the responses that best describes this person now.

Select all that apply.

• 1: No, not First Nations, Métis or Inuk (Inuit)
• 2: Yes, First Nations (North American Indian)
• 3: Yes, Métis
• 4: Yes, Inuk (Inuit)

Population group (PG) - Question identifier:PG_R05

The following question collects information in accordance with the Employment Equity Act and its Regulations and Guidelines to support programs that promote equal opportunity for everyone to share in the social, cultural, and economic life of Canada.

Population group (PG) - Question identifier:PG_Q05

Are you?

Select all that apply.

• 01: White
• 02: South Asian (e.g., East Indian, Pakistani, Sri Lankan)
• 03: Chinese
• 04: Black
• 05: Filipino
• 06: Arab
• 07: Latin American
• 08: Southeast Asian (e.g. Vietnamese, Cambodian, Laotian, Thai)
• 09: West Asian (e.g., Iranian, Afghan)
• 10: Korean
• 11: Japanese
• 12: Other — specify:

Language (LAN) - Question identifier:LAN_Q01

Can you speak English or French well enough to conduct a conversation?

• 1: English only
• 2: French only
• 3: Both English and French
• 4: Neither English nor French

Language (LAN) - Question identifier:LAN_Q02

What language do you speak most often at home?

Select all that apply.

• 1: English
• 2: French
• 3: Other

Language (LAN) - Question identifier:LAN_Q04

What is the language that you first learned at home in childhood and still understand?

If you no longer understand the first language learned, indicate the second language learned.

Select all that apply.

• 1: English
• 2: French
• 3: Other

Sexual orientation (SOR) - Question identifier:SOR_Q01

What is your sexual orientation?

• 1: Heterosexual
• 2: Lesbian or gay
• 3: Bisexual
• 4: Or please specify

Sexual behaviour (SXB2) - Question identifier:SXB2_R05

Now a question about sexual activity. The information gathered will be helpful in distinguishing groups at risk for adverse health outcomes such as sexually transmitted and blood-borne infections (STBBIs) like human immunodeficiency virus (HIV) and hepatitis C virus (HCV). This information can be used to determine populations at higher risk for these adverse health outcomes, allowing for more targeted approaches that increase access to prevention, treatment, and care programs for these populations.

Sexual behaviour (SXB2) - Question identifier:SXB2_Q05

In the past 12 months, have you had sex?

Include vaginal and anal sex.

• 1: Yes
• 2: No

Sexual behaviour (SXB2) - Question identifier:SXB2_Q10

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

Respond based on the sex assigned at birth of your sexual partners.
Include vaginal and anal sex.

Select all that apply.

• 1: Male(s)
• 2: Female(s)

Home care services (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.

Home care services (HMC) - Question identifier:HMC_Q005

In the past 12 months, what type of home care services have been received?

Include services provided at home such as nursing care, meal preparation, someone to help with bathing or housework, etc.

Exclude post-partum care, help from family, friends or neighbours.

Select all that apply.

• 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 (e.g., bathing, housekeeping, meal preparation)
• 5: Palliative or end-of-life care
• 6: Other services (e.g., transportation, meals-on-wheels)
• 7: No one in the household received any home care services

Home care services (HMC) - Question identifier:HMC_Q010A

Who received these home care services?
Nursing care

e.g., dressing changes, preparing medications, V.O.N. visits

• 1: You
• 2: Another member of the household
• 3: You and another member of the household

Home care services (HMC) - Question identifier:HMC_Q010B

Who received these home care services?
Other health care services

e.g., physiotherapy, occupational or speech therapy, nutrition counselling

• 1: You
• 2: Another member of the household
• 3: You and another member of the household

Home care services (HMC) - Question identifier:HMC_Q010C

Who received these home care services?
Medical equipment or supplies

e.g., wheelchair, pads for incontinence, help with using a ventilator or oxygen equipment

• 1: You
• 2: Another member of the household
• 3: You and another member of the household

Home care services (HMC) - Question identifier:HMC_Q010D

Who received these home care services?
Personal or home support

e.g., bathing, housekeeping, meal preparation

• 1: You
• 2: Another member of the household
• 3: You and another member of the household

Home care services (HMC) - Question identifier:HMC_Q010E

Who received these home care services?
Palliative or end-of-life care

• 1: You
• 2: Another member of the household
• 3: You and another member of the household

Home care services (HMC) - Question identifier:HMC_Q010F

Who received these home care services?
Other services

e.g., transportation, meals-on-wheels

• 1: You
• 2: Another member of the household
• 3: You and another member of the household

Home care services (HMC) - Question identifier:HMC_Q015A

How long were home care services received?
Nursing care

e.g., dressing changes, preparing medications

If more than one household member is receiving a service, choose the longest period of time for which the service was provided.

• 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

Home care services (HMC) - Question identifier:HMC_Q015B

How long were home care services received?
Other health care services

e.g., physiotherapy, occupational or speech therapy, nutrition counselling.

If more than one household member is receiving a service, choose the longest period of time for which the service was provided.

• 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

Home care services (HMC) - Question identifier:HMC_Q015C

How long were home care services received?
Medical equipment or supplies

e.g., wheelchair, pads for incontinence, help with using a ventilator or oxygen equipment.

If more than one household member is receiving a service, choose the longest period of time for which the service was provided.

• 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

Home care services (HMC) - Question identifier:HMC_Q015D

How long were home care services received?
Personal or home support

e.g., bathing, housekeeping, meal preparation.

If more than one household member is receiving a service, choose the longest period of time for which the service was provided.

• 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

Home care services (HMC) - Question identifier:HMC_Q015E

How long were home care services received?
Palliative or end-of-life care

If more than one household member is receiving a service, choose the longest period of time for which the service was provided.

• 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

Home care services (HMC) - Question identifier:HMC_Q015F

How long were home care services received?
Other services

e.g., transportation, meals-on-wheels.

If more than one household member is receiving a service, choose the longest period of time for which the service was provided.

• 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

Home care services (HMC) - Question identifier:HMC_Q020A

In a typical month over the past 12 months, how much was paid for home care services?
Nursing care

e.g., dressing changes, preparing medications

If more than one household member is receiving a service, choose the highest cost paid for the service.

• 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 $1,000
• 08: $1,000 and more

Home care services (HMC) - Question identifier:HMC_Q020B

In a typical month over the past 12 months, how much was paid for home care services?
Other health care services

e.g., physiotherapy, occupational or speech therapy, nutrition counselling.

If more than one household member is receiving a service, choose the highest cost paid for the service.

• 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 $1,000
• 08: $1,000 and more

Home care services (HMC) - Question identifier:HMC_Q020C

In a typical month over the past 12 months, how much was paid for home care services?
Medical equipment or supplies

e.g., wheelchair, pads for incontinence, help with using a ventilator or oxygen equipment.

If more than one household member is receiving a service, choose the highest cost paid for the service.

• 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 $1,000
• 08: $1,000 and more

Home care services (HMC) - Question identifier:HMC_Q020D

In a typical month over the past 12 months, how much was paid for home care services?
Personal or home support

e.g., bathing, housekeeping, meal preparation.

If more than one household member is receiving a service, choose the highest cost paid for the service.

• 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 $1,000
• 08: $1,000 and more

Home care services (HMC) - Question identifier:HMC_Q020E

In a typical month over the past 12 months, how much was paid for home care services?
Palliative or end-of-life care

If more than one household member is receiving a service, choose the highest cost paid for the service.

• 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 $1,000
• 08: $1,000 and more

Home care services (HMC) - Question identifier:HMC_Q020F

In a typical month over the past 12 months, how much was paid for home care services?
Other services

e.g., transportation, meals-on-wheels.
If more than one household member is receiving a service, choose the highest cost paid for the service.

• 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 $1,000
• 08: $1,000 and more

Home care services (HMC) - Question identifier:HMC_Q025

Who paid for these services?

Select all that apply.

• 1: Out of your 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

Home care services (HMC) - Question identifier:HMC_Q030

Overall, what was the level of satisfaction for the home care services received?

• 1: Very satisfied
• 2: Somewhat satisfied
• 3: Neither satisfied nor dissatisfied
• 4: Somewhat dissatisfied
• 5: Very dissatisfied

Home care services (HMC) - Question identifier:HMC_Q035

What are the reasons for the dissatisfaction?

Select all that apply.

• 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

Home care services (HMC) - Question identifier:HMC_Q037

Thinking of the home care services received in the past 12 months, how helpful were they in allowing the person or persons receiving these services to stay at home?

By "stay at home" we mean that it enabled the person to stay out of a hospital, nursing home, hospice, or assisted living facility.

• 1: Very helpful
• 2: Somewhat helpful
• 3: Not helpful
• 4: Reason for homecare was unrelated to staying at home (e.g., wound care)

Home care services (HMC) - Question identifier:HMC_Q038

Why weren't the home care services helpful in allowing the person or persons receiving these services to stay at home?

Select all that apply.

• 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 (e.g., coverage, frequency, etc.)
• 4: Long wait times to receive services
• 5: Cost of services was too high
• 6: Other reason

Home care services (HMC) - Question identifier:HMC_Q040

During the past 12 months, was there ever a time when you or anyone in the household felt that home care services were needed but were not received?

• 1: Yes
• 2: No

Home care services (HMC) - Question identifier:HMC_Q045

Were these home care services needed for yourself or someone else living in the household?

• 1: You only
• 2: Other household member
• 3: You and other household member

Home care services (HMC) - Question identifier:HMC_R050

For the following questions, please only report for the home care services you personally needed.

Home care services (HMC) - Question identifier:HMC_Q050

Thinking of the most recent time, what type of home care was needed?

Select all that apply.

• 1: Nursing care (e.g., dressing changes, preparing medications)
• 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 (e.g., bathing, housekeeping, meal preparation)
• 5: Palliative or end-of-life care
• 6: Other services (e.g., transportation, meals-on-wheels)

Home care services (HMC) - Question identifier:HMC_Q055

Again, thinking of the most recent time, why didn't you or another member of the household get these services?

Select all that apply.

• 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 or didn't bother
• 06: Didn't know where to go or 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

Home care services (HMC) - Question identifier:HMC_Q060

Where did you or another member of the household try to get these home care services?

Select all that apply.

• 1: A government Home Care Program (e.g., CLSC in Quebec, Ontario Health atHome, Extra-Mural 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

Insurance coverage - long term care (INL) - Question identifier:INL_Q05

Do you have insurance that covers all or part of the cost of ^DT_YOURINS_E long-term care, including home care?

Include coverage from your own plan or someone else's.

e.g., private, government or employer-paid plans.

• 1: Yes
• 2: No
• 3: Don't know

Prescription cost (PCN) - Question identifier:PCN_Q05

In the past 12 months, did [you] have any prescriptions for medication?

• 1: Yes
• 2: No

Prescription cost (PCN) - Question identifier:PCN_Q10

In the past 12 months, did [you] do any of the following because of the cost of [your] prescriptions?

Select all that apply.

• 1: Not fill a prescription
• 2: Not collect a prescription
• 3: Skip doses of [your] medicine
• 4: Reduce the dosage of [your] medication
• 5: Delay filling a prescription
• 6: Or None of the above

Food security (FSC) - Question identifier:FSC_R05

The following statements may describe the food situation for your household in the past 12 months.

Food security (FSC) - Question identifier:FSC_R10

Please indicate if the statement was often true, sometimes true or never true for [you/you and other household members] worried that food would run out before you got money to buy more in the past 12 months.

Food security (FSC) - Question identifier:FSC_Q10

[You/You and other household members] worried that food would run out before you got money to buy moreworried that food would run out before you got money to buy more

• 1: Often true
• 2: Sometimes true
• 3: Never true

Food security (FSC) - Question identifier:FSC_Q15

The food that [you/you and other household members] worried that food would run out before you got money to buy morebought just didn't last and there wasn't any money to get more

• 1: Often true
• 2: Sometimes true
• 3: Never true

Food security (FSC) - Question identifier:FSC_Q20

[You/You and other household members] couldn't afford to eat balanced meals

• 1: Often true
• 2: Sometimes true
• 3: Never true

Food security (FSC) - Question identifier:FSC_Q25

[You/You or other adults in your household] relied on only a few kinds of low-cost food to feed [your child/the children] because you were running out of money to buy food

• 1: Often true
• 2: Sometimes true
• 3: Never true

Food security (FSC) - Question identifier:FSC_Q30

[You/You or other adults in your household] couldn't feed [your child/the children] a balanced meal because you couldn't afford it

• 1: Often true
• 2: Sometimes true
• 3: Never true

Food security (FSC) - Question identifier:FSC_Q35

[Your child was/The children were] not eating enough because [you/you or other adults in your household] just couldn't afford enough food?

• 1: Often true
• 2: Sometimes true
• 3: Never true

Food security (FSC) - Question identifier:FSC_R40

[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_Q40

In the past 12 months, since last [January/ February/ March/ April/ May/ June/ July/ August/ September/ October/ November/ December], did [you/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

Food security (FSC) - Question identifier:FSC_Q45

How often did this happen?

• 1: Almost every month
• 2: Some months but not every month
• 3: Only 1 or 2 months

Food security (FSC) - Question identifier:FSC_Q50

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

Food security (FSC) - Question identifier:FSC_Q55

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

Food security (FSC) - Question identifier:FSC_Q60

In the past 12 months, did you personally ever lose weight because you didn't have enough money for food?

• 1: Yes
• 2: No

Food security (FSC) - Question identifier:FSC_Q65

In the past 12 months, did [you/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

Food security (FSC) - Question identifier:FSC_Q70

How often did this happen?

• 1: Almost every month
• 2: Some months but not every month
• 3: Only 1 or 2 months

Food security (FSC) - Question identifier:FSC_R75

Now, a few questions on the food experiences for children in your household.

Food security (FSC) - Question identifier:FSC_Q75

In the past 12 months, did [you/you or other adults in your household] ever cut the size of [your child's/any of the children's] meals because there wasn't enough money for food?

• 1: Yes
• 2: No

Food security (FSC) - Question identifier:FSC_Q80

In the past 12 months, did [your child/any of the children] ever skip meals because there wasn't enough money for food?

• 1: Yes
• 2: No

Food security (FSC) - Question identifier:FSC_Q85