Canadian National Health Survey
Archived Content
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For Information onlyThis is an electronic survey example for information purposes only. This is not a working questionnaire.
Table of Contents
- Proxy interview (GR)
- Age of respondent (ANC1)
- Relationship without confirmation (RNC)
- Main activity (MAC)
- General health (GEN)
- Height and weight - self reported (HWT)
- Chronic conditions (CCC)
- Health utility index (HUI)
- Activities of daily living (ADL)
- Injuries (INJ)
- Oral health (OHT)
- Dental care (DEN)
- Changes made to improve health (CIH)
- Sleep (SLP)
- Fruit and vegetable consumption (FVC)
- Food choices (FDC)
- Canada's Food Guide use (FGU)
- Smoking (SMK)
- Smoking - stages of change (SCH)
- Smoking cessation methods (SCA)
- Tobacco products alternatives (TAL)
- Nicotine dependence (NDE)
- Exposure to second hand smoke (ETS)
- Alcohol use (ALC)
- Alcohol use during the past week (ALW)
- Medication use (MED)
- Drug use methods (DRM)
- Drug use (DRG)
- Problem gambling (CPG)
- Physical activities - adults 18 years and older (PAA)
- Physical activities for youth (PAY)
- Use of protective equipment (UPE)
- Sun safety behaviours (SSB)
- Sedentary activities (SAC)
- Maternal experiences (MEX)
- Smoking during maternal experience (MXS)
- Alcohol use during maternal experience (MXA)
- Driving and safety (DRV)
- Flu shots (FLU)
- Physical check-up (PCU)
- Blood pressure check (BPC)
- Pap smear test (PAP)
- Mammography (MAM)
- Prostate cancer screening (PSA)
- Colorectal cancer screening (CCS)
- Spirometry (SPI)
- Diabetes care (DIA)
- Eye examinations (EYX)
- Consultations about mental health (CMH)
- Satisfaction with life (SWL)
- Depression (DEP)
- Suicidal thoughts and attempts (SUI)
- Work stress (WST)
- Sources of stress (STS)
- Social provisions (SPS)
- Primary health care (PHC)
- Medical Doctor Attachment (MDA)
- Contacts with health professionals - part 1 (CHP)
- Patient satisfaction - community-based care (PSC)
- Patient experiences (PEX)
- Access to health care services (ACC)
- Waiting times (WTM)
- Home care services (HMC)
- Unmet health care needs (UCN)
- Labour force (LBF)
- Loss of productivity (LOP)
- Socio-demographic characteristics (SDC)
- Person most knowledgeable about household situation (PMK)
- Health insurance coverage (INS)
- Food security (FSC)
- Administration information (ADM)
- Sexual behaviours (SXB)
Proxy interview (GR)
Proxy interview (GR) - Question identifier:GR_N005
Who is providing the information for this person's component?
- 01: MEMBER1
- 02: MEMBER2
- 03: MEMBER3
- 04: MEMBER4
- 05: MEMBER5
- 06: MEMBER6
- 07: MEMBER7
- 08: MEMBER8
- 09: MEMBER9
- 10: MEMBER10
- 11: MEMBER11
- 12: MEMBER12
- 13: MEMBER13
- 14: MEMBER14
- 15: MEMBER15
- 16: MEMBER16
- 17: MEMBER17
- 18: MEMBER18
- 19: MEMBER19
- 20: MEMBER20
- 88: Not a household member
Proxy interview (GR) - Question identifier:GR_N010
Do you want to complete this component by proxy?
- 1: Yes
- 2: No
Proxy interview (GR) - Question identifier:GR_N015
Record the reason why this component is being completed by proxy. Proxy interviews are to occur only if the mental or physical health of the selected member makes it impossible to complete the interview during the collection period. If the reason for the proxy interview is neither of these choices, please press <F10> to exit the application and assign an appropriate outcome code.
- 1: Physical health condition
- 2: Mental health condition
Proxy interview (GR) - Question identifier:GR_N020
Enter the condition.
Long Answer Length = 80
Age of respondent (ANC1)
Age of respondent (ANC1) - Question identifier:ANC1_Q01
What is ^SPECRESPNAME's date of birth?
Min = 1; Max = 31
Age of respondent (ANC1) - Question identifier:ANC1_Q02
(What is ^SPECRESPNAME's date of birth?)
- 01: January
- 02: February
- 03: March
- 04: April
- 05: May
- 06: June
- 07: July
- 08: August
- 09: September
- 10: October
- 11: November
- 12: December
- 98: RF
- 99: DK
Age of respondent (ANC1) - Question identifier:ANC1_Q03
(What is ^SPECRESPNAME's date of birth?)
Min = 0; Max = 9997
Age of respondent (ANC1) - Question identifier:ANC1_Q04
So ^SPECRESPNAME's age on ^REFERENCEDATEE was ^DV_CALCULATEDAGE ^DT_YEARSMONTHSE.
Is that correct?
- 1: Yes
- 2: No, return and correct date of birth
- 3: No, collect age
Age of respondent (ANC1) - Question identifier:ANC1_Q05
What is ^SPECRESPNAME's age?
Min = 0; Max = 121
Age of respondent (ANC1) - Question identifier:ANC1_R010
Because you are less than 12 years old, you are not eligible to participate in the Canadian National Health Survey.
Age of respondent (ANC1) - Question identifier:ANC1_R015
Because you are more than 17 years old, you are not eligible to participate in the Canadian National Health Survey.
Age of respondent (ANC1) - Question identifier:ANC1_R020
Because you are less than 18 years old, you are not eligible to participate in the Canadian National Health Survey.
Age of respondent (ANC1) - Question identifier:ANC1_N030
Please confirm the spelling of respondent's first name. Update first name, if necessary.
Original First Name: ^FNAME
Original Last Name: ^LNAME
Long Answer Length = 25
Age of respondent (ANC1) - Question identifier:ANC1_N035
Please confirm the spelling of respondent's last name. Update last name, if necessary.
Original First Name: ^FNAME
Original Last Name: ^LNAME
Long Answer Length = 25
Relationship without confirmation (RNC)
Relationship without confirmation (RNC) - Question identifier:RNC_Q1
What is the relationship...
of: ^SPECRESPNAME1 (^SPECRESPAGE1, ^DT_SPECRESPSEXE1)
to: ^SPECRESPNAME2 (^SPECRESPAGE2, ^DT_SPECRESPSEXE2)?
- 01: (Husband/Wife)
- 02: Common-law partner
- 03: (Father/Mother)
- 04: (Son/Daughter)
- 05: (Brother/Sister)
- 06: (Father/Mother)
- 07: Foster (Son/Daughter)
- 08: (Grandfather/Grandmother)
- 09: (Grandson/Granddaughter)
- 10: In-law
- 11: Other related
- 12: Unrelated
- 98: RF
- 99: DK
Relationship without confirmation (RNC) - Question identifier:RNC_Q2A
Is that a(n)... ?
- 1: Birth (father/mother)
- 2: Step(father/mother)
- 3: Adoptive (father/mother)
- 8: RF
- 9: DK
Relationship without confirmation (RNC) - Question identifier:RNC_Q2B
Is that a(n)... ?
- 1: Birth (son/daughter)
- 2: Step (son/daughter)
- 3: Adopted (son/daughter)
- 8: RF
- 9: DK
Relationship without confirmation (RNC) - Question identifier:RNC_Q2C
Is that a(n)... ?
- 1: Full (brother/sister)
- 2: Half (brother/sister)
- 3: Step(brother/sister)
- 4: Adopted (brother/sister)
- 5: Foster (brother/sister)
- 8: RF
- 9: DK
Relationship without confirmation (RNC) - Question identifier:RNC_Q2D
Is that a(n)... ?
- 1: (Father/Mother)-in-law
- 2: (Son/Daughter)-in-law
- 3: (Brother/Sister)-in-law
- 4: Other in-law
- 8: RF
- 9: DK
Relationship without confirmation (RNC) - Question identifier:RNC_Q2E
Is that a(n)... ?
- 1: (Uncle/Aunt)
- 2: Cousin
- 3: (Nephew/Neice)
- 4: Other relative
- 8: RF
- 9: DK
Relationship without confirmation (RNC) - Question identifier:RNC_Q2F
Is that a(n)... ?
- 1: (Boyfriend/Girlfriend)
- 2: Roommate/lodger/boarder
- 3: Other - Specify
- 8: RF
- 9: DK
Main activity (MAC)
Main activity (MAC) - Question identifier:MAC_Q005
Last week, was your main activity working at a paid job or business, looking for paid work, going to school, caring for children, household work, retired or something else?
- 01: Working at a paid job or business
- 02: Vacation (from paid work)
- 03: Looking for paid work
- 04: Going to school (including vacation from school)
- 05: Caring for children
- 06: Household work
- 07: Retired
- 08: Maternity/paternity leave
- 09: Long term illness
- 10: Volunteering
- 11: Care-giving other than for children
- 12: Other
- 98: RF
- 99: DK
Main activity (MAC) - Question identifier:MAC_Q010
Have you worked at a job or business at any time in the past 12 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Main activity (MAC) - Question identifier:MAC_Q015
Are you currently attending school, college, CEGEP or university?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Main activity (MAC) - Question identifier:MAC_Q020
Are you enrolled as...?
- 1: A full-time student
- 2: A part-time student
- 3: Both full-time and part-time student
- 8: RF
- 9: DK
Main activity (MAC) - Question identifier:MAC_Q025
To better understand the information you will provide on your health it is important to know if you are pregnant. Are you pregnant?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
General health (GEN)
General health (GEN) - Question identifier:GEN_R005
The next questions are about your health. By health, we mean not only the absence of disease or injury but also physical, mental and social well-being.
General health (GEN) - Question identifier:GEN_Q005
In general, would you say your health is... ?
- 1: Excellent
- 2: Very good
- 3: Good
- 4: Fair
- 5: Poor
- 8: RF
- 9: DK
General health (GEN) - Question identifier:GEN_Q010
Using a scale of 0 to 10, where 0 means "Very dissatisfied" and 10 means "Very satisfied", how do you feel about your life as a whole right now?
Min = 0; Max = 10
General health (GEN) - Question identifier:GEN_Q015
In general, would you say your mental health is...?
- 1: Excellent
- 2: Very good
- 3: Good
- 4: Fair
- 5: Poor
- 8: RF
- 9: DK
General health (GEN) - Question identifier:GEN_Q020
Thinking about the amount of stress in your life, would you say that most of your days are...?
- 1: Not at all stressful
- 2: Not very stressful
- 3: A bit stressful
- 4: Quite a bit stressful
- 5: Extremely stressful
- 8: RF
- 9: DK
General health (GEN) - Question identifier:GEN_R025
The next question is about your main job or business in the past 12 months.
General health (GEN) - Question identifier:GEN_Q025
Would you say that most days at work were...?
- 1: Not at all stressful
- 2: Not very stressful
- 3: A bit stressful
- 4: Quite a bit stressful
- 5: Extremely stressful
- 8: RF
- 9: DK
General health (GEN) - Question identifier:GEN_Q030
How would you describe your sense of belonging to your local community? Would you say it is...?
- 1: Very strong
- 2: Somewhat strong
- 3: Somewhat weak
- 4: Very weak
- 8: RF
- 9: DK
Height and weight - self reported (HWT)
Height and weight - self reported (HWT) - Question identifier:HWT_Q005
The next questions are about height and weight. How tall are you without shoes on?
- 0: Less than 1' / 12" (less than 29.2 cm.)
- 1: 1'0" to 1'11" / 12" to 23" (29.2 to 59.6 cm.)
- 2: 2'0" to 2'11" / 24" to 35" (59.7 to 90.1 cm.)
- 3: 3'0" to 3'11" / 36" to 47" (90.2 to 120.6 cm.)
- 4: 4'0" to 4'11" / 48" to 59" (120.7 to 151.0 cm.)
- 5: 5'0" to 5'11" (151.1 to 181.5 cm.)
- 6: 6'0" to 6'11" (181.6 to 212.0 cm.)
- 7: 7'0" and over (212.1 cm. and over)
- 8: RF
- 9: DK
Height and weight - self reported (HWT) - Question identifier:HWT_N010
Select the exact height.
- 00: Less than or equal to 1'0" / 12" (29.2 to 31.7 cm.)
- 01: 1'1" / 13" (31.8 to 34.2 cm.)
- 02: 1'2" / 14" (34.3 to 36.7 cm.)
- 03: 1'3" / 15" (36.8 to 39.3 cm.)
- 04: 1'4" / 16" (39.4 to 41.8 cm.)
- 05: 1'5" / 17" (41.9 to 44.4 cm.)
- 06: 1'6" / 18" (44.5 to 46.9 cm.)
- 07: 1'7" / 19" (47.0 to 49.4 cm.)
- 08: 1'8" / 20" (49.5 to 52.0 cm.)
- 09: 1'9" / 21" (52.1 to 54.5 cm.)
- 10: 1'10" / 22" (54.6 to 57.1 cm.)
- 11: 1'11" / 23" (57.2 to 59.6 cm.)
- 98: RF
- 99: DK
Height and weight - self reported (HWT) - Question identifier:HWT_N015
Select the exact height.
- 00: 2'0" / 24" (59.7 to 62.1 cm.)
- 01: 2'1" / 25" (62.2 to 64.7 cm.)
- 02: 2'2" / 26" (64.8 to 67.2 cm.)
- 03: 2'3" / 27" (67.3 to 69.8 cm.)
- 04: 2'4" / 28" (69.9 to 72.3 cm.)
- 05: 2'5" / 29" (72.4 to 74.8 cm.)
- 06: 2'6" / 30" (74.9 to 77.4 cm.)
- 07: 2'7" / 31" (77.5 to 79.9 cm.)
- 08: 2'8" / 32" (80.0 to 82.5 cm.)
- 09: 2'9" / 33" (82.6 to 85.0 cm.)
- 10: 2'10" / 34" (85.1 to 87.5 cm.)
- 11: 2'11" / 35" (87.6 to 90.1 cm.)
- 98: RF
- 99: DK
Height and weight - self reported (HWT) - Question identifier:HWT_N020
Select the exact height.
- 00: 3'0" / 36" (90.2 to 92.6 cm.)
- 01: 3'1" / 37" (92.7 to 95.2 cm.)
- 02: 3'2" / 38" (95.3 to 97.7 cm.)
- 03: 3'3" / 39" (97.8 to 100.2 cm.)
- 04: 3'4" / 40" (100.3 to 102.8 cm.)
- 05: 3'5" / 41" (102.9 to 105.3 cm.)
- 06: 3'6" / 42" (105.4 to 107.9 cm.)
- 07: 3'7" / 43" (108.0 to 110.4 cm.)
- 08: 3'8" / 44" (110.5 to 112.9 cm.)
- 09: 3'9" / 45" (113.0 to 115.5 cm.)
- 10: 3'10" / 46" (115.6 to 118.0 cm.)
- 11: 3'11" / 47" (118.1 to 120.6 cm.)
- 98: RF
- 99: DK
Height and weight - self reported (HWT) - Question identifier:HWT_N025
Select the exact height.
- 00: 4'0" / 48" (120.7 to 123.1 cm.)
- 01: 4'1" / 49" (123.2 to 125.6 cm.)
- 02: 4'2" / 50" (125.7 to 128.2 cm.)
- 03: 4'3" / 51" (128.3 to 130.7 cm.)
- 04: 4'4" / 52" (130.8 to 133.3 cm.)
- 05: 4'5" / 53" (133.4 to 135.8 cm.)
- 06: 4'6" / 54" (135.9 to 138.3 cm.)
- 07: 4'7" / 55" (138.4 to 140.9 cm.)
- 08: 4'8" / 56" (141.0 to 143.4 cm.)
- 09: 4'9" / 57" (143.5 to 146.0 cm.)
- 10: 4'10" / 58" (146.1 to 148.5 cm.)
- 11: 4'11" / 59" (148.6 to 151.0 cm.)
- 98: RF
- 99: DK
Height and weight - self reported (HWT) - Question identifier:HWT_N030
Select the exact height.
- 00: 5'0" (151.1 to 153.6 cm.)
- 01: 5'1" (153.7 to 156.1 cm.)
- 02: 5'2" (156.2 to 158.7 cm.)
- 03: 5'3" (158.8 to 161.2 cm.)
- 04: 5'4" (161.3 to 163.7 cm.)
- 05: 5'5" (163.8 to 166.3 cm.)
- 06: 5'6" (166.4 to 168.8 cm.)
- 07: 5'7" (168.9 to 171.4 cm.)
- 08: 5'8" (171.5 to 173.9 cm.)
- 09: 5'9" (174.0 to 176.4 cm.)
- 10: 5'10" (176.5 to 179.0 cm.)
- 11: 5'11" (179.1 to 181.5 cm.)
- 98: RF
- 99: DK
Height and weight - self reported (HWT) - Question identifier:HWT_N035
Select the exact height.
- 00: 6'0" (181.6 to 184.1 cm.)
- 01: 6'1" (184.2 to 186.6 cm.)
- 02: 6'2" (186.7 to 189.1 cm.)
- 03: 6'3" (189.2 to 191.7 cm.)
- 04: 6'4" (191.8 to 194.2 cm.)
- 05: 6'5" (194.3 to 196.8 cm.)
- 06: 6'6" (196.9 to 199.3 cm.)
- 07: 6'7" (199.4 to 201.8 cm.)
- 08: 6'8" (201.9 to 204.4 cm.)
- 09: 6'9" (204.5 to 206.9 cm.)
- 10: 6'10" (207.0 to 209.5 cm.)
- 11: 6'11" (209.6 to 212.0 cm.)
- 98: RF
- 99: DK
Height and weight - self reported (HWT) - Question identifier:HWT_Q040
How much do you weigh?
Min = 1; Max = 575
Height and weight - self reported (HWT) - Question identifier:HWT_N045
Was that in pounds or kilograms?
- 1: Pounds
- 2: Kilograms
Height and weight - self reported (HWT) - Question identifier:HWT_Q050
Do you consider yourself...?
- 1: Overweight
- 2: Underweight
- 3: Just about right
- 8: RF
- 9: DK
Chronic conditions (CCC)
Chronic conditions (CCC) - Question identifier:CCC_R005
The next question refers to your joints. Please do not include the back or neck.
Chronic conditions (CCC) - Question identifier:CCC_Q005
During the past 30 days, have you had any symptoms of pain, aching, or stiffness in or around a joint?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q010
Did your joint symptoms first begin more than 3 months ago?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_R015
Now I'd like to ask about certain long-term health conditions which you may have. We are interested in "long-term conditions" which are expected to last or have already lasted 6 months or more and that have been diagnosed by a health professional.
Chronic conditions (CCC) - Question identifier:CCC_Q015
Do you have asthma?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q020
Have you had any asthma symptoms or asthma attacks in the past 12 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q025
In the past 12 months, have you taken any medicine for asthma such as inhalers (pumps), nebulizers, pills, liquids or injections?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q030
Do you have chronic bronchitis, emphysema or chronic obstructive pulmonary disease or COPD?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q035
Have you been told by a health professional that you have sleep apnea?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q040
Do you have scoliosis?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_R045
Remember, we're interested in conditions diagnosed by a health professional and that are expected to last or have already lasted 6 months or more.
Chronic conditions (CCC) - Question identifier:CCC_Q045
Do you have fibromyalgia?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q050
Do you have arthritis, for example osteoarthritis, rheumatoid arthritis, gout or any other type, excluding fibromyalgia?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q055
Do you have back problems, excluding scoliosis, fibromyalgia and arthritis?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q060
Do you have osteoporosis?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q065
Do you have high blood pressure?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q070
In the past month, have you taken any medicine for high blood pressure?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q075
Do you have high blood cholesterol or lipids?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q080
In the past month, have you taken any medicine for high blood cholesterol or lipids?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q085
Do you have heart disease?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q090
Do you suffer from the effects of a stroke?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q095
Do you have diabetes?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q100
How old were you when this was first diagnosed?
Min = 1; Max = 121
Chronic conditions (CCC) - Question identifier:CCC_Q105
Were you pregnant when you were first diagnosed with diabetes?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q110
Other than during pregnancy, has a health professional ever told you that you have diabetes?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q115
When you were first diagnosed with diabetes, how long was it before you were started on insulin?
- 1: Less than 1 month
- 2: 1 month to less than 2 months
- 3: 2 months to less than 6 months
- 4: 6 months to less than 1 year
- 5: 1 year or more
- 6: Never
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q120
Do you currently take insulin for your diabetes?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q125
In the past month, did you take pills to control your blood sugar?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q130
Do you have cancer?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q135
Have you ever been diagnosed with cancer?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_R140
Remember, we're interested in conditions diagnosed by a health professional and that are expected to last or have already lasted 6 months or more.
Chronic conditions (CCC) - Question identifier:CCC_Q140
Do you have migraine headaches?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q145
Do you have Alzheimer's Disease or any other dementia?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q150
Do you have intestinal or stomach ulcers?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q155
Do you have a bowel disorder such as Crohn's Disease, ulcerative colitis, Irritable Bowel Syndrome or bowel incontinence?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q160
What kind of bowel disease do you have?
- 1: Crohn's Disease
- 2: Ulcerative colitis
- 3: Irritable Bowel Syndrome
- 4: Bowel incontinence
- 5: Other
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q165
Do you have urinary incontinence?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q170
As a result of allergy tests, were you ever told by a health professional that you had allergies?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q175
What did your health professional say you were allergic to?
- 01: Certain foods
- 02: Certain animals
- 03: Dust mites
- 04: Mould
- 05: Pollens or grasses
- 06: Chemicals
- 07: Certain medicine
- 08: Other
- 98: RF
- 99: DK
Chronic conditions (CCC) - Question identifier:CCC_Q180
Were you ever told by a doctor that you have hay fever or nasal allergy?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q185
Do you have chronic fatigue syndrome?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q190
Do you suffer from multiple chemical sensitivities?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q195
Do you have a mood disorder such as depression, bipolar disorder, mania or dysthymia?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q200
Do you have an anxiety disorder such as a phobia, obsessive-compulsive disorder or a panic disorder?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health utility index (HUI)
Health utility index (HUI) - Question identifier:HUI_R001
The next set of questions asks about your day-to-day health.
You may feel that some of these questions do not apply to you, but it is important that we ask the same questions of everyone.
Health utility index (HUI) - Question identifier:HUI_Q005
Are you usually able to see well enough to read ordinary newsprint without glasses or contact lenses?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_Q010
Are you usually able to see well enough to read ordinary newsprint with glasses or contact lenses?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_Q015
Are you able to see at all?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_Q020
Are you able to see well enough to recognize a friend on the other side of the street without glasses or contact lenses?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_Q025
Are you usually able to see well enough to recognize a friend on the other side of the street with glasses or contact lenses?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_Q030
Are you usually able to hear what is said in a group conversation with at least three other people without a hearing aid?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_Q035
Are you usually able to hear what is said in a group conversation with at least three other people with a hearing aid?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_Q040
Are you able to hear at all?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_Q045
Are you usually able to hear what is said in a conversation with one other person in a quiet room without a hearing aid?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_Q050
Are you usually able to hear what is said in a conversation with one other person in a quiet room with a hearing aid?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_Q055
Are you usually able to be understood completely when speaking with strangers in your own language?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_Q060
Are you able to be understood partially when speaking with strangers?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_Q065
Are you able to be understood completely when speaking with those who know you well?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_Q070
Are you able to be understood partially when speaking with those who know you well?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_Q075
Are you usually able to walk around the neighbourhood without difficulty and without mechanical support such as braces, a cane or crutches?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_Q080
Are you able to walk at all?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_Q085
Do you require mechanical support such as braces, a cane or crutches to be able to walk around the neighbourhood?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_Q090
Do you require the help of another person to be able to walk?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_Q095
Do you require a wheelchair to get around?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_Q100
How often do you use a wheelchair?
- 1: Always
- 2: Often
- 3: Sometimes
- 4: Never
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_Q105
Do you need the help of another person to get around in the wheelchair?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_Q110
Are you usually able to grasp and handle small objects such as a pencil or scissors?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_Q115
Do you require the help of another person because of limitations in the use of your hands or fingers?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_Q120
Do you require the help of another person with...?
- 1: Some tasks
- 2: Most tasks
- 3: Almost all tasks
- 4: All tasks
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_Q125
Do you require special equipment, for example, devices to assist in dressing, because of limitations in the use of your hands or fingers?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_Q130
Would you describe [yourself] as being usually...?
- 1: Happy and interested in life
- 2: Somewhat happy
- 3: Somewhat unhappy
- 4: Unhappy with little interest in life
- 5: So unhappy, that life is not worthwhile
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_Q135
How would you describe your usual ability to remember things?
- 1: Able to remember most things
- 2: Somewhat forgetful
- 3: Very forgetful
- 4: Unable to remember anything at all
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_Q140
How would you describe your usual ability to think and solve day-to-day problems?
- 1: Able to think clearly and solve problems
- 2: Having a little difficulty
- 3: Having some difficulty
- 4: Having a great deal of difficulty
- 5: Unable to think or solve problems
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_R145
The next set of questions asks about the level of pain or discomfort you usually experience. They are not about illnesses like colds that affect people for short periods of time.
Health utility index (HUI) - Question identifier:HUI_Q145
Are you usually free of pain or discomfort?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_Q150
How would you describe the usual intensity of your pain or discomfort?
- 1: Mild
- 2: Moderate
- 3: Severe
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_Q155
How many activities does your pain or discomfort prevent?
- 1: None
- 2: A few
- 3: Some
- 4: Most
- 8: RF
- 9: DK
Activities of daily living (ADL)
Activities of daily living (ADL) - Question identifier:ADL_R001
The next few questions are about common daily activities. 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_Q005
Because of any physical condition, mental condition or health problem, do you have any difficulty:
with preparing meals?
- 1: No, you have no difficulty
- 2: Yes, you have difficulty, but do not require help of others
- 3: Yes, you have difficulty, but can do it with the help of others
- 4: [You] cannot do it at all
- 8: RF
- 9: DK
Activities of daily living (ADL) - Question identifier:ADL_Q010
Because of any physical condition, mental condition or health problem, do you have any difficulty:
with running errands such as shopping for groceries?
- 1: No, you have no difficulty
- 2: Yes, you have difficulty, but do not require help of others
- 3: Yes, you have difficulty, but can do it with the help of others
- 4: [You] cannot do it at all
- 8: RF
- 9: DK
Activities of daily living (ADL) - Question identifier:ADL_Q015
(Because of any physical condition, mental condition or health problem, do you have any difficulty:)
with doing everyday housework?
- 1: No, you have no difficulty
- 2: Yes, you have difficulty, but do not require help of others
- 3: Yes, you have difficulty, but can do it with the help of others
- 4: [You] cannot do it at all
- 8: RF
- 9: DK
Activities of daily living (ADL) - Question identifier:ADL_Q020
(Because of any physical condition, mental condition or health problem, do you have any difficulty:)
with personal care such as bathing, dressing, eating or taking medication?
- 1: No, you have no difficulty
- 2: Yes, you have difficulty, but do not require help of others
- 3: Yes, you have difficulty, but can do it with the help of others
- 4: [You] cannot do it at all
- 8: RF
- 9: DK
Activities of daily living (ADL) - Question identifier:ADL_Q025
Because of any physical condition, mental condition or health problem, do you have any difficulty:
with moving about inside the house?
- 1: No, you have no difficulty
- 2: Yes, you have difficulty, but do not require help of others
- 3: Yes, you have difficulty, but can do it with the help of others
- 4: [You] cannot do it at all
- 8: RF
- 9: DK
Activities of daily living (ADL) - Question identifier:ADL_Q030
(Because of any physical condition, mental condition or health problem, do you have any difficulty:)
with looking after your personal finances such as making bank transactions or paying bills?
- 1: No, you have no difficulty
- 2: Yes, you have difficulty, but do not require help of others
- 3: Yes, you have difficulty, but can do it with the help of others
- 4: [You] cannot do it at all
- 8: RF
- 9: DK
Injuries (INJ)
Injuries (INJ) - Question identifier:INJ_R001
Now, questions on repetitive strain injuries. By this we mean injuries to muscles, tendons or nerves caused by overuse or repeating the same movement over an extended period. For example, carpal tunnel syndrome, tennis elbow or tendonitis.
Injuries (INJ) - Question identifier:INJ_Q005
In the past 12 months, did you have any injuries due to repetitive strain?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Injuries (INJ) - Question identifier:INJ_Q010
Were these injuries serious enough to limit your normal activities?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Injuries (INJ) - Question identifier:INJ_Q015
Thinking about the most serious repetitive strain injury, what part of the body was affected?
- 01: Head
- 02: Neck
- 03: Shoulder, upper arm
- 04: Elbow, lower arm
- 05: Wrist
- 06: Hand
- 07: Hip
- 08: Thigh
- 09: Knee, lower leg
- 10: Ankle, foot
- 11: Upper back or upper spine (excluding neck)
- 12: Lower back or lower spine
- 13: Chest (excluding back and spine)
- 14: Abdomen or pelvis (excluding back and spine)
- 98: RF
- 99: DK
Injuries (INJ) - Question identifier:INJ_Q020
What type of activity caused this repetitive strain injury?
- 01: Walking
- 02: Sports or physical exercise (including school activities and running)
- 03: Leisure or hobby (include volunteering)
- 04: Household chores, outdoor yard maintenance, home renovations or other unpaid work
- 05: Computer use or typing
- 06: Driving a motor vehicle
- 07: Lifting or carrying an object or person
- 08: Other
- 98: RF
- 99: DK
Injuries (INJ) - Question identifier:INJ_Q025
Was the activity something you did while working at your job or business (excluding travel to or from work)?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Injuries (INJ) - Question identifier:INJ_R030
For the next questions, think about [other] injuries which occurred in the past 12 months, and were serious enough to limit your normal activities at least 24 hours after the injury occurred. For example, a broken bone, a bad cut, a burn or a sprain.
Injuries (INJ) - Question identifier:INJ_Q030
[Not counting repetitive strain injuries or food poisoning,] in the past 12 months, that is, from [CURRENTDATE - 1] to yesterday, were you injured?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Injuries (INJ) - Question identifier:INJ_Q035
How many times were you injured?
Min = 1; Max = 30
Injuries (INJ) - Question identifier:INJ_Q040
[Thinking about the most serious injury, in which] month did it happen?
- 01: January
- 02: February
- 03: March
- 04: April
- 05: May
- 06: June
- 07: July
- 08: August
- 09: September
- 10: October
- 11: November
- 12: December
- 98: RF
- 99: DK
Injuries (INJ) - Question identifier:INJ_Q045
Was that this year or last year?
- 1: This year
- 2: Last year
- 8: RF
- 9: DK
Injuries (INJ) - Question identifier:INJ_Q050
What type of injury did you have? For example, a broken bone or burn.
- 01: Multiple serious injuries (excluding multiple minor injuries)
- 02: Broken or fractured bones
- 03: Burn, scald, chemical burn
- 04: Dislocation
- 05: Sprain or strain (including torn ligaments and muscles)
- 06: Cut, puncture, animal or human bite (open wound)
- 07: Scrape(s), bruise(s), blister(s) (including multiple minor injuries)
- 08: Concussion or other brain injury
- 09: Poisoning (excluding food poisoning, poison ivy, other contact dermatitis, and allergies)
- 10: Injury to internal organs
- 11: Other - Specify
- 98: RF
- 99: DK
Injuries (INJ) - Question identifier:INJ_Q055
What part of the body was injured?
- 01: Multiple sites
- 02: Eyes (excluding fracture of facial bones around the eye)
- 03: Head (including facial bones)
- 04: Neck
- 05: Shoulder, upper arm
- 06: Elbow, lower arm
- 07: Wrist
- 08: Hand
- 09: Hip
- 10: Thigh
- 11: Knee, lower leg
- 12: Ankle, foot
- 13: Upper back or upper spine (excluding neck)
- 14: Lower back or lower spine
- 15: Chest (excluding back and spine)
- 16: Abdomen or pelvis (excluding back and spine)
- 17: Other
- 98: RF
- 99: DK
Injuries (INJ) - Question identifier:INJ_Q060
Where were you when you were injured? For example, someone's house, an office building, construction site.
- 01: In a home or its surrounding area (including respondent's home or other homes)
- 02: Residential institution (e.g., nursing home, long term care)
- 03: School, college, university (exclude sports areas)
- 04: Sports or athletics area of school, college, university
- 05: Other sports or athletics area (exclude school sports areas)
- 06: Other institution (e.g., church, hospital, theatre, civic building)
- 07: Street, highway, sidewalk
- 08: Commercial area (e.g., store, restaurant, office building, transport terminal)
- 09: Industrial or construction area
- 10: Farm (exclude farmhouse and its surrounding area)
- 11: Countryside, forest, lake, ocean, mountains, prairie, etc.
- 12: Other
- 98: RF
- 99: DK
Injuries (INJ) - Question identifier:INJ_Q065
What were you doing when you were injured?
- 01: Organized sports involving coaching and competitions
- 02: Leisure sports or physical exercise, including school activities and running
- 03: Non-sport leisure or hobby (including volunteering)
- 04: Working at a job or business (excluding travel to and from work)
- 05: Household chores, outdoor yard maintenance, home renovations or other unpaid work
- 06: Sleeping, eating, personal care
- 07: Going up and down stairs
- 08: Driver or passenger in/on road motor vehicle (including motorcycles and trucks)
- 09: Driver or passenger in/on off-road motor vehicle (including boat, ATV, snowmobile)
- 10: Walking
- 11: Other - Specify
- 98: RF
- 99: DK
Injuries (INJ) - Question identifier:INJ_Q070
Was the injury the result of a fall?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Injuries (INJ) - Question identifier:INJ_Q075
How did you fall?
- 01: While skating, skiing or snowboarding
- 02: While engaged in other sport or physical exercise (including school activities and running)
- 03: Going up or down stairs / steps (icy or not)
- 04: Slip, trip or stumble, or loss of balance while walking on ice or snow
- 05: Slip, trip or stumble, or loss of balance while walking on any other surface
- 06: From furniture or while rising from furniture (e.g., bed, chair)
- 07: From elevated position (e.g., ladder, tree, scaffolding)
- 08: Due to health problems (e.g., faint, weakness, dizziness, hip/knee gave out, seizure)
- 09: Other - Specify
- 98: RF
- 99: DK
Injuries (INJ) - Question identifier:INJ_Q080
What caused the injury? For example, wrong movement, accidental contact with an object, transportation accident.
- 01: Transportation accident
- 02: Accidentally bumped, pushed, bitten, etc. by a person or animal
- 03: Accidentally struck or crushed by object(s)
- 04: Accidental contact with sharp object, tool or machine
- 05: Smoke, fire, flames
- 06: Accidental contact with hot object, liquid or gas
- 07: Extreme weather or natural disaster
- 08: Overexertion or strenuous movement
- 09: Physical assault
- 10: Intentional self-inflicted injury
- 11: Other - Specify
- 98: RF
- 99: DK
Injuries (INJ) - Question identifier:INJ_Q085
At what time of day did your injury occur?
- 1: Morning (06:00-11:59)
- 2: Afternoon (12:00-17:59)
- 3: Evening (18:00-23:59)
- 4: Night (00:00-05:59)
- 8: RF
- 9: DK
Injuries (INJ) - Question identifier:INJ_Q090
Did you receive any medical attention for the injury from a health professional in the 48 hours following the injury?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Injuries (INJ) - Question identifier:INJ_Q095
Where did you initially go to receive treatment within the first 48 hours following the injury?
- 01: Doctor's office
- 02: Hospital emergency room
- 03: Hospital outpatient clinic (e.g., day surgery)
- 04: Other clinic (e.g., walk-in, appointment, sports)
- 05: Physiotherapist or massage therapist's office
- 06: Community health centre / CLSC
- 07: Chiropractor's office
- 08: Where the injury happened/on-site (workplace, school, sports field, hotel, ski hill)
- 09: Other
- 98: RF
- 99: DK
Injuries (INJ) - Question identifier:INJ_Q100
Were you admitted to a hospital overnight because of this injury?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Injuries (INJ) - Question identifier:INJ_Q105
At the present time, are you getting follow-up care from a health professional because of this injury?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Injuries (INJ) - Question identifier:INJ_Q110
In the past 12 months, [, excluding injuries previously mentioned, did] you have any other injuries that were treated by a health professional, but did not limit your normal activities?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Injuries (INJ) - Question identifier:INJ_Q115
How many injuries?
Min = 1; Max = 30
Oral health (OHT)
Oral health (OHT) - Question identifier:OHT_R001
Now, some questions about the health of your mouth, including your teeth or dentures, tongue, gums, lips and jaw joints.
Oral health (OHT) - Question identifier:OHT_Q005
In general, would you say the health of your mouth is...?
- 1: Excellent
- 2: Very good
- 3: Good
- 4: Fair
- 5: Poor
- 8: RF
- 9: DK
Oral health (OHT) - Question identifier:OHT_Q010
How satisfied are you with the appearance of your teeth and/or dentures?
- 1: Very satisfied
- 2: Satisfied
- 3: Neither satisfied nor dissatisfied
- 4: Dissatisfied
- 5: Very dissatisfied
- 8: RF
- 9: DK
Oral health (OHT) - Question identifier:OHT_Q015
In the past 12 months, how often have you found it uncomfortable to eat any food because of problems with your mouth?
- 1: Often
- 2: Sometimes
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Oral health (OHT) - Question identifier:OHT_Q020
(In the past 12 months,) how often have you avoided eating particular foods because of problems with your mouth?
- 1: Often
- 2: Sometimes
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Oral health (OHT) - Question identifier:OHT_Q025
Remember, by mouth we mean teeth, dentures, tongue, gums, lips and jaw joints.
In the past 12 months, how often have you had any other persistent or on-going pain anywhere in your mouth?
- 1: Often
- 2: Sometimes
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Oral health (OHT) - Question identifier:OHT_Q030
Do you have at least one of your own teeth?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Oral health (OHT) - Question identifier:OHT_Q035
Do you wear dentures, dental prosthesis or false teeth?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Oral health (OHT) - Question identifier:OHT_Q040
In the past 12 months, how often have you had bleeding gums, including while brushing or flossing your teeth?
- 1: Often
- 2: Sometimes
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Oral health (OHT) - Question identifier:OHT_Q045
(In the past 12 months,) how often have you had persistent dry mouth?
- 1: Often
- 2: Sometimes
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Oral health (OHT) - Question identifier:OHT_Q050
(In the past 12 months,) how often have you had persistent bad breath?
- 1: Often
- 2: Sometimes
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Dental care (DEN)
Dental care (DEN) - Question identifier:DEN_R001
The next questions are about dental care.
Dental care (DEN) - Question identifier:DEN_Q005
Do you have at least one of your own teeth?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Dental care (DEN) - Question identifier:DEN_Q010
How often do you usually brush your teeth?
Min = 0; Max = 500
Dental care (DEN) - Question identifier:DEN_N010A
Select the reporting period.
- 1: By day
- 2: By week
- 3: By month
- 4: By year
Dental care (DEN) - Question identifier:DEN_Q015
How often do you usually floss your teeth?
Min = 0; Max = 500
Dental care (DEN) - Question identifier:DEN_N015A
Select the reporting period.
- 1: By day
- 2: By week
- 3: By month
- 4: By year
Dental care (DEN) - Question identifier:DEN_Q020
Do you wear dentures, dental prosthesis or false teeth?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Dental care (DEN) - Question identifier:DEN_Q025
How often do you usually clean your dentures or dental prosthesis?
Min = 0; Max = 500
Dental care (DEN) - Question identifier:DEN_N025A
Select the reporting period.
- 1: By day
- 2: By week
- 3: By month
- 4: By year
Dental care (DEN) - Question identifier:DEN_Q030
How often do you usually see a dental professional, such as a dentist, a dental hygienist or a denturologist?
- 1: More than once a year for check-ups or treatment
- 2: About once a year (for check-ups or treatment)
- 3: Less than once a year (for check-ups or treatment)
- 4: Only for emergency care
- 5: Never
- 8: RF
- 9: DK
Dental care (DEN) - Question identifier:DEN_Q035
When was the last time you saw a dental professional?
- 1: Less than 1 year to 1 year ago
- 2: More than 1 year to 2 years ago
- 3: More than 2 years to 3 years ago
- 4: More than 3 years to 4 years ago
- 5: More than 4 years to 5 years ago
- 6: More than 5 years ago
- 7: Never
- 8: RF
- 9: DK
Dental care (DEN) - Question identifier:DEN_Q040
In the past 12 months, have you avoided going to a dental professional because of the cost of dental care?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Dental care (DEN) - Question identifier:DEN_Q045
Do you have insurance or a government program that covers all or part of your dental expenses?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Dental care (DEN) - Question identifier:DEN_Q050
Is it...?
- 1: An employer-sponsored plan
- 2: A provincial or territorial government program for children or seniors
- 3: A private plan
- 4: A government program for social service (welfare) clients
- 5: A government program for First Nations and Inuit
- 6: Other
- 8: RF
- 9: DK
Changes made to improve health (CIH)
Changes made to improve health (CIH) - Question identifier:CIH_Q005
Now, some questions about changes made to improve health.
In the past 12 months, did you do anything to improve your health? (For example, lost weight, quit smoking, increased exercise.)
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Changes made to improve health (CIH) - Question identifier:CIH_Q010
What is the single most important change you have made?
- 01: Increased exercise, sports / physical activity
- 02: Lost weight
- 03: Changed diet / improved eating habits
- 04: Quit smoking / reduced amount smoked
- 05: Drank less alcohol
- 06: Reduced stress level
- 07: Received medical treatment
- 08: Took vitamins
- 09: Other
- 98: RF
- 99: DK
Changes made to improve health (CIH) - Question identifier:CIH_Q015
Do you think there is [anything else/anything] you should do to improve your physical health?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Changes made to improve health (CIH) - Question identifier:CIH_Q020
What is the most important thing?
- 01: Start / Increase exercise, sports / physical activity
- 02: Lose weight
- 03: Change diet / improve eating habits
- 04: Quit smoking / reduce amount smoked
- 05: Drink less alcohol
- 06: Reduce stress level
- 07: Receive medical treatment
- 08: Take vitamins
- 09: Other
- 98: RF
- 99: DK
Changes made to improve health (CIH) - Question identifier:CIH_Q025
Is there anything stopping you from making this improvement?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Changes made to improve health (CIH) - Question identifier:CIH_Q030
What is that?
- 01: Lack of will power / self-discipline
- 02: Family responsibilities
- 03: Work schedule
- 04: Addiction to drugs / alcohol
- 05: Disability / health condition
- 06: Too stressed
- 07: Too costly / financial constraints
- 08: Not available in area
- 09: Transportation problems
- 10: Weather problems
- 11: Other
- 98: RF
- 99: DK
Changes made to improve health (CIH) - Question identifier:CIH_Q035
Is there anything you intend to do to improve your physical health in the next year?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Changes made to improve health (CIH) - Question identifier:CIH_Q040
What is that?
- 01: Start / Increase exercise, sports / physical activity
- 02: Lose weight
- 03: Change diet / improve eating habits
- 04: Quit smoking / reduce amount smoked
- 05: Drink less alcohol
- 06: Reduce stress level
- 07: Receive medical treatment
- 08: Take vitamins
- 09: Other
- 98: RF
- 99: DK
Sleep (SLP)
Sleep (SLP) - Question identifier:SLP_R001
Now a few questions about sleep.
Sleep (SLP) - Question identifier:SLP_Q005
How long do you usually spend sleeping each night?
- 01: Under 2 hours
- 02: 2 hours to less than 3 hours
- 03: 3 hours to less than 4 hours
- 04: 4 hours to less than 5 hours
- 05: 5 hours to less than 6 hours
- 06: 6 hours to less than 7 hours
- 07: 7 hours to less than 8 hours
- 08: 8 hours to less than 9 hours
- 09: 9 hours to less than 10 hours
- 10: 10 hours to less than 11 hours
- 11: 11 hours to less than 12 hours
- 12: 12 hours or more
- 98: RF
- 99: DK
Sleep (SLP) - Question identifier:SLP_Q010
How often do you have trouble going to sleep or staying asleep?
- 1: Never
- 2: Rarely
- 3: Sometimes
- 4: Most of the time
- 5: All of the time
- 8: RF
- 9: DK
Sleep (SLP) - Question identifier:SLP_Q015
How often do you find your sleep refreshing?
- 1: Never
- 2: Rarely
- 3: Sometimes
- 4: Most of the time
- 5: All of the time
- 8: RF
- 9: DK
Sleep (SLP) - Question identifier:SLP_Q020
How often do you find it difficult to stay awake when you want to?
- 1: Never
- 2: Rarely
- 3: Sometimes
- 4: Most of the time
- 5: All of the time
- 8: RF
- 9: DK
Fruit and vegetable consumption (FVC)
Fruit and vegetable consumption (FVC) - Question identifier:FVC_R001
These next questions are about the fruits and vegetables you ate or drank during the past month. Please report your consumption either per day, per week or per month. Think about all meals and snacks, at home and away from home.
Fruit and vegetable consumption (FVC) - Question identifier:FVC_Q005
In the last month, how many times per day, per week or per month did you drink 100% PURE fruit juices, such as pure orange juice, apple juice or pure juice blends? Do not include fruit-flavored drinks with added sugar or fruit punch.
Min = 0; Max = 300
Fruit and vegetable consumption (FVC) - Question identifier:FVC_N005A
Select the reporting period that corresponds to FVC_Q005.
- 1: Per day
- 2: Per week
- 3: Per month
Fruit and vegetable consumption (FVC) - Question identifier:FVC_Q010
In the last month, not counting juice, how many times did you eat fruit? Please remember to include frozen, dried or canned fruit.
Min = 0; Max = 300
Fruit and vegetable consumption (FVC) - Question identifier:FVC_N010A
Select the reporting period that corresponds to FVC_Q010.
- 1: Per day
- 2: Per week
- 3: Per month
Fruit and vegetable consumption (FVC) - Question identifier:FVC_Q015
In the last month, how many times did you eat dark green vegetables such as broccoli, green beans, peas and green peppers or dark leafy greens including romaine or spinach? Please remember to include (frozen or canned vegetables and) vegetables that were cooked in soups or mixed in salad.
Min = 0; Max = 300
Fruit and vegetable consumption (FVC) - Question identifier:FVC_N015A
Select the reporting period that corresponds to FVC_Q015.
- 1: Per day
- 2: Per week
- 3: Per month
Fruit and vegetable consumption (FVC) - Question identifier:FVC_Q020
In the last month, how many times did you eat orange-colored vegetables such as carrots, orange bell pepper, sweet potatoes, pumpkin or squash? (Please remember to include frozen or canned vegetables and vegetables that were cooked in soups or mixed in salad).
Min = 0; Max = 300
Fruit and vegetable consumption (FVC) - Question identifier:FVC_N020A
Select the reporting period that corresponds to FVC_Q020.
- 1: Per day
- 2: Per week
- 3: Per month
Fruit and vegetable consumption (FVC) - Question identifier:FVC_Q025
In the last month, how many times per day, per week or per month did you eat potatoes that are not deep fried?
Min = 0; Max = 300
Fruit and vegetable consumption (FVC) - Question identifier:FVC_N025A
Select the reporting period that corresponds to FVC_Q025.
- 1: Per day
- 2: Per week
- 3: Per month
Fruit and vegetable consumption (FVC) - Question identifier:FVC_Q030
Excluding the green and orange vegetables as well as the potatoes you have already reported, in the last month, how many times did you eat OTHER vegetables? Examples include cucumber, celery, corn, cabbage and vegetable juice.
Min = 0; Max = 300
Fruit and vegetable consumption (FVC) - Question identifier:FVC_N030A
Select the reporting period that corresponds to FVC_Q030.
- 1: Per day
- 2: Per week
- 3: Per month
Food choices (FDC)
Food choices (FDC) - Question identifier:FDC_R001
Now, some questions about the foods you eat.
Food choices (FDC) - Question identifier:FDC_Q005
Do you choose certain foods or avoid others:
because you are concerned about your body weight?
- 1: Yes (or sometimes)
- 2: No
- 8: RF
- 9: DK
Food choices (FDC) - Question identifier:FDC_Q010
Do you choose certain foods or avoid others:
because you are concerned about heart disease?
- 1: Yes (or sometimes)
- 2: No
- 8: RF
- 9: DK
Food choices (FDC) - Question identifier:FDC_Q015
(Do you choose certain foods or avoid others:)
because you are concerned about cancer?
- 1: Yes (or sometimes)
- 2: No
- 8: RF
- 9: DK
Food choices (FDC) - Question identifier:FDC_Q020
(Do you choose certain foods or avoid others:)
because you are concerned about osteoporosis (brittle bones)?
- 1: Yes (or sometimes)
- 2: No
- 8: RF
- 9: DK
Food choices (FDC) - Question identifier:FDC_Q025
Do you choose certain foods because of:
the lower fat content?
- 1: Yes (or sometimes)
- 2: No
- 8: RF
- 9: DK
Food choices (FDC) - Question identifier:FDC_Q030
(Do you choose certain foods because of:)
the fibre content?
- 1: Yes (or sometimes)
- 2: No
- 8: RF
- 9: DK
Food choices (FDC) - Question identifier:FDC_Q035
(Do you choose certain foods because of:)
the calcium content?
- 1: Yes (or sometimes)
- 2: No
- 8: RF
- 9: DK
Food choices (FDC) - Question identifier:FDC_Q040
Do you avoid certain foods because of:
the fat content?
- 1: Yes (or sometimes)
- 2: No
- 8: RF
- 9: DK
Food choices (FDC) - Question identifier:FDC_Q045
(Do you avoid certain foods because of:)
the type of fat they contain?
- 1: Yes (or sometimes)
- 2: No
- 8: RF
- 9: DK
Food choices (FDC) - Question identifier:FDC_Q050
(Do you avoid certain foods because of:)
the salt content?
- 1: Yes (or sometimes)
- 2: No
- 8: RF
- 9: DK
Food choices (FDC) - Question identifier:FDC_Q055
Do you avoid certain foods because of:
the cholesterol content?
- 1: Yes (or sometimes)
- 2: No
- 8: RF
- 9: DK
Food choices (FDC) - Question identifier:FDC_Q060
(Do you avoid certain foods because of:)
the calorie content?
- 1: Yes (or sometimes)
- 2: No
- 8: RF
- 9: DK
Canada's Food Guide use (FGU)
Canada's Food Guide use (FGU) - Question identifier:FGU_Q005
Have you ever seen or heard of Canada's Food Guide?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Canada's Food Guide use (FGU) - Question identifier:FGU_Q010
Have you ever used information from Canada's Food Guide?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Canada's Food Guide use (FGU) - Question identifier:FGU_Q015
What did you use the information for?
- 1: To choose foods for [you or household members]
- 2: To determine how much [you or household members] need to eat every day
- 3: To plan meals or to help with grocery shopping
- 4: To assess how well [you or household members] are eating
- 5: Other
- 6: None of the above
- 8: RF
- 9: DK
Smoking (SMK)
Smoking (SMK) - Question identifier:SMK_R001
The next questions are about cigarette smoking.
Smoking (SMK) - Question identifier:SMK_Q005
At the present time, do you smoke cigarettes every day, occasionally or not at all?
- 1: Daily
- 2: Occasionally
- 3: Not at all
- 8: RF
- 9: DK
Smoking (SMK) - Question identifier:SMK_Q010
In the past 30 days, did you smoke any cigarettes?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Smoking (SMK) - Question identifier:SMK_Q015
During the past 30 days, did you smoke every day?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Smoking (SMK) - Question identifier:SMK_Q020
Have you smoked more than 100 cigarettes (about 4 packs) in your life?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Smoking (SMK) - Question identifier:SMK_Q025
Have you ever smoked a whole cigarette?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Smoking (SMK) - Question identifier:SMK_Q030
Have you ever smoked cigarettes daily?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Smoking (SMK) - Question identifier:SMK_Q035
At what age did you smoke your first whole cigarette?
Min = 5; Max = 121
Smoking (SMK) - Question identifier:SMK_Q040
At what age did you begin to smoke cigarettes daily?
Min = 5; Max = 121
Smoking (SMK) - Question identifier:SMK_Q045
How many cigarettes do you smoke each day now?
Min = 1; Max = 99
Smoking (SMK) - Question identifier:SMK_Q050
On the days that you do smoke, how many cigarettes do you usually smoke?
Min = 1; Max = 99
Smoking (SMK) - Question identifier:SMK_Q055
In the past month, on how many days have you smoked one or more cigarettes?
Min = 0; Max = 31
Smoking (SMK) - Question identifier:SMK_Q060
When did you stop smoking? Was it...?
- 1: Less than one year ago
- 2: 1 year to less than 2 years ago
- 3: 2 years to less than 3 years ago
- 4: 3 or more years ago
- 8: RF
- 9: DK
Smoking (SMK) - Question identifier:SMK_Q065
In what month did you stop?
- 01: January
- 02: February
- 03: March
- 04: April
- 05: May
- 06: June
- 07: July
- 08: August
- 09: September
- 10: October
- 11: November
- 12: December
- 98: RF
- 99: DK
Smoking (SMK) - Question identifier:SMK_Q070
How many years ago was it?
Min = 3; Max = 121
Smoking (SMK) - Question identifier:SMK_Q075
When you smoked every day, how many cigarettes did you usually smoke each day?
Min = 1; Max = 99
Smoking (SMK) - Question identifier:SMK_Q080
When did you stop smoking daily? Was it...?
- 1: Less than one year ago
- 2: 1 year to less than 2 years ago
- 3: 2 years to less than 3 years ago
- 4: 3 or more years ago
- 8: RF
- 9: DK
Smoking (SMK) - Question identifier:SMK_Q085
In what month did you stop?
- 01: January
- 02: February
- 03: March
- 04: April
- 05: May
- 06: June
- 07: July
- 08: August
- 09: September
- 10: October
- 11: November
- 12: December
- 98: RF
- 99: DK
Smoking (SMK) - Question identifier:SMK_Q090
How many years ago was it?
Min = 3; Max = 121
Smoking (SMK) - Question identifier:SMK_Q095
Was that when you completely quit smoking?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Smoking (SMK) - Question identifier:SMK_Q100
When did you stop smoking completely? Was it...?
- 1: Less than one year ago
- 2: 1 year to less than 2 years ago
- 3: 2 years to less than 3 years ago
- 4: 3 or more years ago
- 8: RF
- 9: DK
Smoking (SMK) - Question identifier:SMK_Q105
In what month did you stop?
- 01: January
- 02: February
- 03: March
- 04: April
- 05: May
- 06: June
- 07: July
- 08: August
- 09: September
- 10: October
- 11: November
- 12: December
- 98: RF
- 99: DK
Smoking (SMK) - Question identifier:SMK_Q110
How many years ago was it?
Min = 3; Max = 121
Smoking - stages of change (SCH)
Smoking - stages of change (SCH) - Question identifier:SCH_Q005
Are you seriously considering quitting smoking within the next 6 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Smoking - stages of change (SCH) - Question identifier:SCH_Q010
Are you seriously considering quitting within the next 30 days?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Smoking - stages of change (SCH) - Question identifier:SCH_Q015
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
- 8: RF
- 9: DK
Smoking - stages of change (SCH) - Question identifier:SCH_Q020
How many times? (in the past 12 months, did you stop smoking for at least 24 hours because you were trying to cut back or quit.)
Min = 1; Max = 95
Smoking cessation methods (SCA)
Smoking cessation methods (SCA) - Question identifier:SCA_Q005
In the past 12 months, did you try a nicotine patch to reduce or quit smoking?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Smoking cessation methods (SCA) - Question identifier:SCA_Q010
How useful was that in helping you reduce or quit smoking?
- 1: Very useful
- 2: Somewhat useful
- 3: Not very useful
- 4: Not useful at all
- 8: RF
- 9: DK
Smoking cessation methods (SCA) - Question identifier:SCA_Q015
In the past 12 months, did you use nicotine gum such as 'Nicorette' to reduce or quit smoking?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Smoking cessation methods (SCA) - Question identifier:SCA_Q020
How useful was that in helping you reduce or quit smoking?
- 1: Very useful
- 2: Somewhat useful
- 3: Not very useful
- 4: Not useful at all
- 8: RF
- 9: DK
Smoking cessation methods (SCA) - Question identifier:SCA_Q025
In the past 12 months, did you try medication such as Zyban, Wellbutrin or Champix to reduce or quit smoking?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Smoking cessation methods (SCA) - Question identifier:SCA_Q030
How useful was that in helping you reduce or quit smoking?
- 1: Very useful
- 2: Somewhat useful
- 3: Not very useful
- 4: Not useful at all
- 8: RF
- 9: DK
Smoking cessation methods (SCA) - Question identifier:SCA_Q035
In the past 12 months, did you stop smoking for at least 24 hours because you were trying to reduce or quit?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Smoking cessation methods (SCA) - Question identifier:SCA_Q040
In the past 12 months, did you try any of the following to reduce or quit smoking:
a nicotine patch?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Smoking cessation methods (SCA) - Question identifier:SCA_Q045
(In the past 12 months, did you try any of the following to reduce or quit smoking:)
nicotine gum such as Nicorette?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Smoking cessation methods (SCA) - Question identifier:SCA_Q050
(In the past 12 months, did you try any of the following to reduce or quit smoking:)
medication such as Zyban, Wellbutrin or Champix?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Tobacco products alternatives (TAL)
Tobacco products alternatives (TAL) - Question identifier:TAL_R001
Now, I would like to ask you a few questions about tobacco products, other than cigarettes.
Tobacco products alternatives (TAL) - Question identifier:TAL_Q005
In the past 30 days, did you smoke any little cigars or cigarillos?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Tobacco products alternatives (TAL) - Question identifier:TAL_Q010
Were these (little cigars or cigarillos) plain, flavoured or both?
- 1: Plain
- 2: Flavoured
- 3: Both
- 8: RF
- 9: DK
Tobacco products alternatives (TAL) - Question identifier:TAL_Q015
In the past 30 days, did you smoke any cigars other than little cigars or cigarillos?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Tobacco products alternatives (TAL) - Question identifier:TAL_Q020
In the past 30 days, did you use an electronic cigarette, also known as an 'e-cigarette'?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Tobacco products alternatives (TAL) - Question identifier:TAL_Q025
(In the past 30 days), did you smoke a pipe?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Tobacco products alternatives (TAL) - Question identifier:TAL_Q030
(In the past 30 days), did you use any chewing tobacco, pinch or snuff?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Tobacco products alternatives (TAL) - Question identifier:TAL_Q035
In the past 30 days, did you smoke a tobacco water-pipe, also known as a hookah, shisha, nargeelay, hubble-bubble or gouza to smoke tobacco?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Nicotine dependence (NDE)
Nicotine dependence (NDE) - Question identifier:NDE_Q005
How soon after you wake up do you smoke your first cigarette?
- 1: Within 5 minutes
- 2: 6 - 30 minutes after waking
- 3: 31 - 60 minutes after waking
- 4: More than 60 minutes after waking
- 8: RF
- 9: DK
Nicotine dependence (NDE) - Question identifier:NDE_Q010
Do you find it difficult to refrain from smoking in places where it is forbidden?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Nicotine dependence (NDE) - Question identifier:NDE_Q015
Which cigarette would you most hate to give up?
- 1: The first one of the day
- 2: Another one
- 8: RF
- 9: DK
Nicotine dependence (NDE) - Question identifier:NDE_Q020
Do you smoke more frequently during the first hours after waking, compared with the rest of the day?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Nicotine dependence (NDE) - Question identifier:NDE_Q025
Do you smoke even if you are so ill that you are in bed most of the day?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Exposure to second hand smoke (ETS)
Exposure to second hand smoke (ETS) - Question identifier:ETS_R001
The next questions are about exposure to second-hand smoke.
Exposure to second hand smoke (ETS) - Question identifier:ETS_Q005
Including both household members and regular visitors, does anyone smoke inside your home, every day or almost every day?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Exposure to second hand smoke (ETS) - Question identifier:ETS_Q010
How many people smoke inside your home every day or almost every day?
Min = 1; Max = 15
Exposure to second hand smoke (ETS) - Question identifier:ETS_Q015
Is smoking allowed inside your home?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Exposure to second hand smoke (ETS) - Question identifier:ETS_Q020
Is smoking inside your home restricted in any way?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Exposure to second hand smoke (ETS) - Question identifier:ETS_Q025
How is smoking restricted inside your home?
- 1: Allowed in certain rooms only
- 2: Restricted in the presence of young children
- 3: Allowed only if windows are open or with another type of ventilation
- 4: Other restriction(s)
- 8: RF
- 9: DK
Exposure to second hand smoke (ETS) - Question identifier:ETS_Q030
In the past month, were you exposed to second-hand smoke, every day or almost every day, at your workplace or at school?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Exposure to second hand smoke (ETS) - Question identifier:ETS_Q035
In the past month, were you exposed to second-hand smoke, every day or almost every day, in a car or other private vehicle?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Exposure to second hand smoke (ETS) - Question identifier:ETS_Q040
In the past month, were you exposed to second-hand smoke, every day or almost every day, in public places (such as bars, restaurants, shopping malls, arenas, bingo halls, bowling alleys)?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Alcohol use (ALC)
Alcohol use (ALC) - Question identifier:ALC_R001
Now, some questions about your alcohol consumption.
A 'drink' refers to:
- a bottle or small can of beer, cider or cooler with 5% alcohol content, or a small draft;
- a glass of wine with 12% alcohol content;
- a glass or cocktail containing 1½ oz. of a spirit with 40% alcohol content.
Alcohol use (ALC) - Question identifier:ALC_Q005
Have you ever had a drink in your lifetime?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Alcohol use (ALC) - Question identifier:ALC_Q010
During the past 12 months, that is, from [CURRENTDATE-1] to yesterday, have you had a drink of beer, wine, liquor or any other alcoholic beverage?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Alcohol use (ALC) - Question identifier:ALC_Q015
During the past 12 months, how often did you drink alcoholic beverages?
- 1: Less than once a month
- 2: Once a month
- 3: 2 to 3 times a month
- 4: Once a week
- 5: 2 to 3 times a week
- 6: 4 to 6 times a week
- 7: Every day
- 8: RF
- 9: DK
Alcohol use (ALC) - Question identifier:ALC_Q020
How often in the past 12 months have you had [5/4] or more drinks on one occasion?
- 1: Never
- 2: Less than once a month
- 3: Once a month
- 4: 2 to 3 times a month
- 5: Once a week
- 6: More than once a week
- 8: RF
- 9: DK
Alcohol use during the past week (ALW)
Alcohol use during the past week (ALW) - Question identifier:ALW_Q005
Thinking back over the past week, that is, from last ^DV_DAYLASTWEEKE to yesterday, did you have a drink of beer, wine, liquor or any other alcoholic beverage?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Alcohol use during the past week (ALW) - Question identifier:ALW_Q010
Starting with yesterday, that is [DAY1_TEXT], how many drinks did you have?
Min = 0; Max = 99
Alcohol use during the past week (ALW) - Question identifier:ALW_Q015
How many drinks did you have:
on [DAY2_TEXT]?
Min = 0; Max = 99
Alcohol use during the past week (ALW) - Question identifier:ALW_Q020
(How many drinks did you have:)
on [DAY3_TEXT]?
Min = 0; Max = 99
Alcohol use during the past week (ALW) - Question identifier:ALW_Q025
(How many drinks did you have:)
on [DAY4_TEXT]?
Min = 0; Max = 99
Alcohol use during the past week (ALW) - Question identifier:ALW_Q030
(How many drinks did you have:)
on [DAY5_TEXT]?
Min = 0; Max = 99
Alcohol use during the past week (ALW) - Question identifier:ALW_Q035
(How many drinks did you have:)
on [DAY6_TEXT]?
Min = 0; Max = 99
Alcohol use during the past week (ALW) - Question identifier:ALW_Q040
(How many drinks did you have:)
on [DAY7_TEXT]?
Min = 0; Max = 99
Medication use (MED)
Medication use (MED) - Question identifier:MED_R001
The next series of questions are about various medications.
The first series of questions are about your use of various pain relievers. By pain relievers, we mean products that contain opioids such as codeine or morphine, or related drugs. Most of these products require a prescription, although some codeine products are available without a prescription, for example, Tylenol #1 or 222s.
We are not interested in pain relievers such as Aspirin, Advil, regular Tylenol, Celebrex, etc.
Medication use (MED) - Question identifier:MED_Q005
During the past 12 months, have you used any codeine products like Tylenol #3, Tylenol #1, 292s or 222s?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Medication use (MED) - Question identifier:MED_Q010
During the past 12 months, have you used any oxycodone products such as Percocet or Percodan?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Medication use (MED) - Question identifier:MED_Q015
(During the past 12 months,) have you used any other opioid products such as hydromorphone, Dilaudid, Hydromorph Contin, morphine, MS Contin, or Demerol?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Medication use (MED) - Question identifier:MED_Q020
(During the past 12 months,) how often did you use any such pain relievers? Would you say...?
- 01: Once or twice
- 02: 3 to 11 times a year
- 03: About once a month
- 04: 2 or 3 times a month
- 05: About once or twice a week
- 06: 3 or 4 times a week
- 07: Daily or almost daily
- 08: As needed, or following surgery
- 98: RF
- 99: DK
Medication use (MED) - Question identifier:MED_Q025
Thinking about all the pain relievers you have used during the past 12 months, were they prescribed for you?
- 1: No, none were prescribed
- 2: Yes, they all were prescribed
- 3: Some were prescribed and others were not
- 8: RF
- 9: DK
Medication use (MED) - Question identifier:MED_Q030
Sometimes people do not take their pills as directed by a physician or pharmacist. Thinking about all the pain relievers you have used during the past 12 months, did you ever take more pills, or take them more often than you were supposed to?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Medication use (MED) - Question identifier:MED_Q035
During the past 12 months, did you ever use pain relievers only for the experience, the feeling they caused or to get high?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Medication use (MED) - Question identifier:MED_Q040
During the past 12 months, did you ever use pain relievers for reasons other than pain relief, for example, to feel better (improve mood), to cope with stress or problems, or any other reason?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Medication use (MED) - Question identifier:MED_Q045
(During the past 12 months,) did you ever tamper with a pain reliever product before taking it, [for example, by crushing tablets to swallow, snort or inject, not counting for ease of swallowing or to take a lower dose]?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Medication use (MED) - Question identifier:MED_R050
The next few questions are about your use of various stimulants.
By stimulants, we mean products prescribed by a doctor to help people who have attention or concentration problems (such as ADHD). Examples of stimulants include Ritalin, Concerta, Adderall, Dexedrine or others.
Medication use (MED) - Question identifier:MED_Q050
During the past 12 months, have you used any stimulants?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Medication use (MED) - Question identifier:MED_Q055
During the past 12 months, how often did you use any stimulants? Would you say...?
- 01: Once or twice
- 02: 3 to 11 times a year
- 03: About once a month
- 04: 2 or 3 times a month
- 05: About once or twice a week
- 06: 3 or 4 times a week
- 07: Daily or almost daily
- 08: As needed, or following surgery
- 98: RF
- 99: DK
Medication use (MED) - Question identifier:MED_Q060
Thinking about all the stimulants you used during the past 12 months, were they prescribed for you?
- 1: No, none were prescribed
- 2: Yes, they all were prescribed
- 3: Some were prescribed and others were not
- 8: RF
- 9: DK
Medication use (MED) - Question identifier:MED_Q065
Sometimes people do not take their pills as directed by a physician or pharmacist. Thinking about all the stimulants you have used during the past 12 months, did you ever take more pills or take them more often than you were supposed to?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Medication use (MED) - Question identifier:MED_Q070
During the past 12 months, did you ever use stimulants only for the experience, the feeling they caused or to get high?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Medication use (MED) - Question identifier:MED_Q075
During the past 12 months, did you ever use stimulants for reasons other than why they were prescribed, for example, to study, to stay alert, to decrease your appetite or for any other reason?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Medication use (MED) - Question identifier:MED_R080
The next few questions are about your use of various sedatives or anti-anxiety medications.
By sedatives, we mean products that can be obtained from a doctor such as diazepam, Valium, lorazepam, Ativan, alprazolam, Xanax, clonazepam, Rivotril or others.
Sedatives are sometimes prescribed to help people sleep, calm down, or to relax their muscles.
Medication use (MED) - Question identifier:MED_Q080
During the past 12 months, have you used any sedatives?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Medication use (MED) - Question identifier:MED_Q085
During the past 12 months, how often did you use any sedatives? Would you say...?
- 01: Once or twice
- 02: 3 to 11 times a year
- 03: About once a month
- 04: 2 or 3 times a month
- 05: About once or twice a week
- 06: 3 or 4 times a week
- 07: Daily or almost daily
- 08: As needed, or following surgery
- 98: RF
- 99: DK
Medication use (MED) - Question identifier:MED_Q090
Thinking about all the sedatives you have used during the past 12 months, were they prescribed for you?
- 1: No, none were prescribed
- 2: Yes, they all were prescribed
- 3: Some were prescribed and others were not
- 8: RF
- 9: DK
Medication use (MED) - Question identifier:MED_Q095
Sometimes people do not take their pills as directed by a physician or pharmacist. Thinking about all the sedatives you have used during the past 12 months, did you ever take more pills or take them more often than you were supposed to?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Medication use (MED) - Question identifier:MED_Q100
During the past 12 months, did you ever use sedatives only for the experience, the feeling they caused or to get high?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Drug use methods (DRM)
Drug use methods (DRM) - Question identifier:DRM_R001
The next questions are about various methods that are used when people use illicit drugs.
Drug use methods (DRM) - Question identifier:DRM_Q005
Have you ever smoked illicit drugs?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Drug use methods (DRM) - Question identifier:DRM_Q010
Was this in the past 12 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Drug use methods (DRM) - Question identifier:DRM_Q015
Have you ever taken illicit drugs orally?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Drug use methods (DRM) - Question identifier:DRM_Q020
Was this in the past 12 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Drug use methods (DRM) - Question identifier:DRM_Q025
Have you ever snorted or sniffed illicit drugs?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Drug use methods (DRM) - Question identifier:DRM_Q030
Was this in the past 12 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Drug use methods (DRM) - Question identifier:DRM_Q035
Have you ever used a needle to inject or be injected with a drug not prescribed by a doctor?
- 1: Yes, just once
- 2: Yes, more than once
- 3: No
- 8: RF
- 9: DK
Drug use methods (DRM) - Question identifier:DRM_Q040
Have you ever used a needle to inject or be injected with a drug not prescribed by a doctor?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Drug use methods (DRM) - Question identifier:DRM_Q045
Was this in the past 12 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Drug use (DRG)
Drug use (DRG) - Question identifier:DRG_R005
I am now going to ask questions on your use of various drugs.
Drug use (DRG) - Question identifier:DRG_Q005
Have you ever used or tried marijuana or hashish?
- 1: Yes, just once
- 2: Yes, more than once
- 3: No
- 8: RF
- 9: DK
Drug use (DRG) - Question identifier:DRG_Q010
Was this in the past 12 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Drug use (DRG) - Question identifier:DRG_Q015
How often did you use marijuana or hashish in the past 12 months?
- 1: Less than once a month
- 2: 1 to 3 times a month
- 3: Once a week
- 4: More than once a week
- 5: Every day
- 8: RF
- 9: DK
Drug use (DRG) - Question identifier:DRG_Q020
Have you ever used or tried cocaine in any form, including crack, freebase, powder or snow?
- 1: Yes, just once
- 2: Yes, more than once
- 3: No
- 8: RF
- 9: DK
Drug use (DRG) - Question identifier:DRG_Q025
Was this in the past 12 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Drug use (DRG) - Question identifier:DRG_Q030
Have you ever used or tried amphetamines, speed, methamphetamines or crystal meth?
- 1: Yes, just once
- 2: Yes, more than once
- 3: No
- 8: RF
- 9: DK
Drug use (DRG) - Question identifier:DRG_Q035
Was this in the past 12 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Drug use (DRG) - Question identifier:DRG_Q040
Have you ever used or tried ecstasy, also known as MDMA, E, Xtc, Adam or X?
- 1: Yes, just once
- 2: Yes, more than once
- 3: No
- 8: RF
- 9: DK
Drug use (DRG) - Question identifier:DRG_Q045
Was this in the past 12 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Drug use (DRG) - Question identifier:DRG_Q050
Have you ever used or tried hallucinogens such as PCP, LSD, acid, magic mushrooms, mescaline or angel dust?
- 1: Yes, just once
- 2: Yes, more than once
- 3: No
- 8: RF
- 9: DK
Drug use (DRG) - Question identifier:DRG_Q055
Was this in the past 12 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Drug use (DRG) - Question identifier:DRG_Q060
Have you ever sniffed glue, gasoline or other solvents to get high?
- 1: Yes, just once
- 2: Yes, more than once
- 3: No
- 8: RF
- 9: DK
Drug use (DRG) - Question identifier:DRG_Q065
Was this in the past 12 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Drug use (DRG) - Question identifier:DRG_Q070
Have you ever used a needle to inject or be injected with a drug not prescribed by a doctor?
- 1: Yes, just once
- 2: Yes, more than once
- 3: No
- 8: RF
- 9: DK
Drug use (DRG) - Question identifier:DRG_Q075
Was this in the past 12 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Drug use (DRG) - Question identifier:DRG_Q080
Which of the following drugs have you injected using a needle?
- 1: Cocaine
- 2: Heroin or opium
- 3: Methamphetamine
- 4: Steroids
- 5: Other
- 6: I have never injected a drug using a needle
- 8: RF
- 9: DK
Problem gambling (CPG)
Problem gambling (CPG) - Question identifier:CPG_R001
The following questions are about the various kinds of gambling activities and experiences that you have had while in Canada. Please note that people have different definitions of gambling.
Problem gambling (CPG) - Question identifier:CPG_R005
In the past 12 months, have you bet or spent money on the following gambling activities:
Problem gambling (CPG) - Question identifier:CPG_Q005
On weekly lottery tickets such as Lotto 6/49 or Lotto Max?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Problem gambling (CPG) - Question identifier:CPG_Q010
How often in the past 12 months (have you bet or spent money on weekly lottery tickets)?
- 1: Daily
- 2: Between 2 and 6 times a week
- 3: About once a week
- 4: 2 or 3 times a month
- 5: About once a month
- 6: Between 6 and 11 times a year
- 7: Between 1 and 5 times a year
- 8: RF
- 9: DK
Problem gambling (CPG) - Question identifier:CPG_Q015
(In the past 12 months, have you bet or spent money) on daily instant win or scratch lottery tickets such as [Set for Life, Pik4, Keno, Gagnant à vie, La Quotidienne 3, Banco, Cash for Life, Pick 3, or Scratch'N Win]?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Problem gambling (CPG) - Question identifier:CPG_Q020
How often in the past 12 months (have you bet or spent money on daily instant win or scratch lottery tickets)?
- 1: Daily
- 2: Between 2 and 6 times a week
- 3: About once a week
- 4: 2 or 3 times a month
- 5: About once a month
- 6: Between 6 and 11 times a year
- 7: Between 1 and 5 times a year
- 8: RF
- 9: DK
Problem gambling (CPG) - Question identifier:CPG_Q025
(In the past 12 months, have you bet or spent money) on sports lotteries such as [Pro-Line, Mise-O-jeu, Prédictions, Point Spread or Pro Picks]?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Problem gambling (CPG) - Question identifier:CPG_Q030
How often in the past 12 months (have you bet or spent money on sports lotteries)?
- 1: Daily
- 2: Between 2 and 6 times a week
- 3: About once a week
- 4: 2 or 3 times a month
- 5: About once a month
- 6: Between 6 and 11 times a year
- 7: Between 1 and 5 times a year
- 8: RF
- 9: DK
Problem gambling (CPG) - Question identifier:CPG_Q035
(In the past 12 months, have you bet or spent money) on slots machines or video lottery terminals (VLTs) at a casino?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Problem gambling (CPG) - Question identifier:CPG_Q040
How often in the past 12 months (have you bet or spent money on video lottery terminals at a casino)?
- 1: Daily
- 2: Between 2 and 6 times a week
- 3: About once a week
- 4: 2 or 3 times a month
- 5: About once a month
- 6: Between 6 and 11 times a year
- 7: Between 1 and 5 times a year
- 8: RF
- 9: DK
Problem gambling (CPG) - Question identifier:CPG_Q045
(In the past 12 months, have you bet or spent money) on casino table games such as poker, baccarat, roulette, blackjack or Keno?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Problem gambling (CPG) - Question identifier:CPG_Q050
How often in the past 12 months (have you bet or spent money on casino table games such as poker, baccarat, roulette, blackjack or Keno)?
- 1: Daily
- 2: Between 2 and 6 times a week
- 3: About once a week
- 4: 2 or 3 times a month
- 5: About once a month
- 6: Between 6 and 11 times a year
- 7: Between 1 and 5 times a year
- 8: RF
- 9: DK
Problem gambling (CPG) - Question identifier:CPG_Q055
(In the past 12 months, have you bet or spent money) on slots machines or video lottery terminals (VLTs) outside of casinos such as in bars, restaurants or taverns?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Problem gambling (CPG) - Question identifier:CPG_Q060
How often in the past 12 months (have you bet or spent money on video lottery terminals outside of casinos such as in bars, restaurants or taverns)?
- 1: Daily
- 2: Between 2 and 6 times a week
- 3: About once a week
- 4: 2 or 3 times a month
- 5: About once a month
- 6: Between 6 and 11 times a year
- 7: Between 1 and 5 times a year
- 8: RF
- 9: DK
Problem gambling (CPG) - Question identifier:CPG_Q065
(In the past 12 months, have you bet or spent money) on Bingo?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Problem gambling (CPG) - Question identifier:CPG_Q070
How often in the past 12 months (have you bet or spent money on Bingo)?
- 1: Daily
- 2: Between 2 and 6 times a week
- 3: About once a week
- 4: 2 or 3 times a month
- 5: About once a month
- 6: Between 6 and 11 times a year
- 7: Between 1 and 5 times a year
- 8: RF
- 9: DK
Problem gambling (CPG) - Question identifier:CPG_Q075
(In the past 12 months, have you bet or spent money) on Kinzo?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Problem gambling (CPG) - Question identifier:CPG_Q080
How often in the past 12 months (have you bet or spent money on Kinzo)?
- 1: Daily
- 2: Between 2 and 6 times a week
- 3: About once a week
- 4: 2 or 3 times a month
- 5: About once a month
- 6: Between 6 and 11 times a year
- 7: Between 1 and 5 times a year
- 8: RF
- 9: DK
Problem gambling (CPG) - Question identifier:CPG_Q085
(In the past 12 months, have you bet or spent money) playing poker on the Internet?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Problem gambling (CPG) - Question identifier:CPG_Q090
How often in the past 12 months (have you bet or spent money playing poker on the Internet)?
- 1: Daily
- 2: Between 2 and 6 times a week
- 3: About once a week
- 4: 2 or 3 times a month
- 5: About once a month
- 6: Between 6 and 11 times a year
- 7: Between 1 and 5 times a year
- 8: RF
- 9: DK
Problem gambling (CPG) - Question identifier:CPG_Q095
(In the past 12 months, have you bet or spent money) on Internet games, excluding poker?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Problem gambling (CPG) - Question identifier:CPG_Q100
How often in the past 12 months (have you bet or spent money on Internet games, excluding poker)?
- 1: Daily
- 2: Between 2 and 6 times a week
- 3: About once a week
- 4: 2 or 3 times a month
- 5: About once a month
- 6: Between 6 and 11 times a year
- 7: Between 1 and 5 times a year
- 8: RF
- 9: DK
Problem gambling (CPG) - Question identifier:CPG_Q105
(In the past 12 months, have you bet or spent money) playing poker or other card games with family or friends?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Problem gambling (CPG) - Question identifier:CPG_Q110
How often in the past 12 months (have you bet or spent money playing poker or other card games with family or friends)?
- 1: Daily
- 2: Between 2 and 6 times a week
- 3: About once a week
- 4: 2 or 3 times a month
- 5: About once a month
- 6: Between 6 and 11 times a year
- 7: Between 1 and 5 times a year
- 8: RF
- 9: DK
Problem gambling (CPG) - Question identifier:CPG_Q115
(In the past 12 months, have you bet or spent money) when playing sports or watching sporting events with family or friends?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Problem gambling (CPG) - Question identifier:CPG_Q120
How often in the past 12 months (have you bet or spent money when playing sports or watching sporting events with family or friends)?
- 1: Daily
- 2: Between 2 and 6 times a week
- 3: About once a week
- 4: 2 or 3 times a month
- 5: About once a month
- 6: Between 6 and 11 times a year
- 7: Between 1 and 5 times a year
- 8: RF
- 9: DK
Problem gambling (CPG) - Question identifier:CPG_Q125
(In the past 12 months, have you bet or spent money) on live horse racing at the track or off-track?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Problem gambling (CPG) - Question identifier:CPG_Q130
How often in the past 12 months (have you bet or spent money on live horse racing at the track or off-track)?
- 1: Daily
- 2: Between 2 and 6 times a week
- 3: About once a week
- 4: 2 or 3 times a month
- 5: About once a month
- 6: Between 6 and 11 times a year
- 7: Between 1 and 5 times a year
- 8: RF
- 9: DK
Problem gambling (CPG) - Question identifier:CPG_Q135
In the past 12 months, have you bet or spent money on any other form of gambling not mentioned above?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Problem gambling (CPG) - Question identifier:CPG_Q140
How often in the past 12 months (have you bet or spent money on any other form of gambling not mentioned above)?
- 1: Daily
- 2: Between 2 and 6 times a week
- 3: About once a week
- 4: 2 or 3 times a month
- 5: About once a month
- 6: Between 6 and 11 times a year
- 7: Between 1 and 5 times a year
- 8: RF
- 9: DK
Problem gambling (CPG) - Question identifier:CPG_Q145
In the past 12 months, how much money, not including winnings, did you spend on all of your gambling activities?
- 1: Between 1 and 100 dollars
- 2: Between 101 and 250 dollars
- 3: Between 251 and 500 dollars
- 4: Between 501 and 1000 dollars
- 5: Between 1001 and 5000 dollars
- 6: More than 5000 dollars
- 8: RF
- 9: DK
Problem gambling (CPG) - Question identifier:CPG_R150
You may feel like some of the following questions do not apply to you; however, it is important that they be asked of all respondents in the survey.
Problem gambling (CPG) - Question identifier:CPG_Q150
In the past 12 months, how often have you bet more than you could really afford to lose?
- 1: Never
- 2: Sometimes
- 3: Most of the time
- 4: Almost always
- 8: RF
- 9: DK
Problem gambling (CPG) - Question identifier:CPG_Q155
(In the past 12 months,) how often have you needed to gamble with larger amounts of money to get the same feeling of excitement?
- 1: Never
- 2: Sometimes
- 3: Most of the time
- 4: Almost always
- 8: RF
- 9: DK
Problem gambling (CPG) - Question identifier:CPG_Q160
(In the past 12 months,) how often have you borrowed money or sold anything to get money to gamble?
- 1: Never
- 2: Sometimes
- 3: Most of the time
- 4: Almost always
- 8: RF
- 9: DK
Problem gambling (CPG) - Question identifier:CPG_Q165
In the past 12 months, when you gambled, how often did you go back another day to try to win back the money you lost?
- 1: Never
- 2: Sometimes
- 3: Most of the time
- 4: Almost always
- 8: RF
- 9: DK
Problem gambling (CPG) - Question identifier:CPG_Q170
(In the past 12 months,) how often have you felt that you might have a problem with gambling?
- 1: Never
- 2: Sometimes
- 3: Most of the time
- 4: Almost always
- 8: RF
- 9: DK
Problem gambling (CPG) - Question identifier:CPG_Q175
(In the past 12 months,) how often has gambling caused you any health problems, including stress or anxiety?
- 1: Never
- 2: Sometimes
- 3: Most of the time
- 4: Almost always
- 8: RF
- 9: DK
Problem gambling (CPG) - Question identifier:CPG_Q180
In the past 12 months, how often have people criticized your betting or told you that you had a gambling problem, regardless of whether or not you thought it was true?
- 1: Never
- 2: Sometimes
- 3: Most of the time
- 4: Almost always
- 8: RF
- 9: DK
Problem gambling (CPG) - Question identifier:CPG_Q185
(In the past 12 months,) how often has your gambling caused financial problems for you or your family?
- 1: Never
- 2: Sometimes
- 3: Most of the time
- 4: Almost always
- 8: RF
- 9: DK
Problem gambling (CPG) - Question identifier:CPG_Q190
(In the past 12 months,) how often have you felt guilty about the way you gamble or what happens when you gamble?
- 1: Never
- 2: Sometimes
- 3: Most of the time
- 4: Almost always
- 8: RF
- 9: DK
Physical activities - adults 18 years and older (PAA)
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_R001
The following questions are about various types of physical activities done in the last 7 days. I want you to only think of activities you did for a minimum of 10 continuous minutes.
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q005
In the last 7 days, that is from last ^DT_DAYLASTWEEKE to yesterday, did you use active ways like walking or cycling to get to places such as work, school, the bus stop, the shopping centre or to visit friends?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q010
In the last 7 days, on which days did you do these activities?
- 1: Monday
- 2: Tuesday
- 3: Wednesday
- 4: Thursday
- 5: Friday
- 6: Saturday
- 7: Sunday
- 8: RF
- 9: DK
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q015
How much time in total, in the last 7 days, did you spend doing these activities? Please only include activities that lasted a minimum of 10 continuous minutes.
Min = 0; Max = 168
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_N020
Enter number of minutes.
Min = 0; Max = 9995
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q030
[Not including activities you just reported, in] the last 7 days, did you do sports, fitness or recreational physical activities, organized or non-organized, that lasted a minimum of 10 continuous minutes?
Examples are walking, home or gym exercise, swimming, cycling, running, skiing, dancing and all team sports.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q035
Did any of these recreational physical activities make you sweat at least a little and breathe harder?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q040
In the last 7 days, on which days did you do these recreational activities that made you sweat at least a little and breathe harder?
- 1: Monday
- 2: Tuesday
- 3: Wednesday
- 4: Thursday
- 5: Friday
- 6: Saturday
- 7: Sunday
- 8: RF
- 9: DK
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q045
(In the last 7 days), how much time in total did you spend doing these activities that made you sweat at least a little and breathe harder?
Min = 0; Max = 168
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_N050
Enter number of minutes.
Min = 0; Max = 9995
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q060
In the last 7 days, did you do any other physical activities while at work, in or around your home or while volunteering?
Examples are carrying heavy loads, shoveling, and household chores such as vacuuming or washing windows. Please remember to only include activities that lasted a minimum of 10 continuous minutes.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q065
Did any of these other physical activities make you sweat at least a little and breathe harder?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q070
In the last 7 days, on which days did you do these other activities that made you sweat at least a little and breathe harder?
- 1: Monday
- 2: Tuesday
- 3: Wednesday
- 4: Thursday
- 5: Friday
- 6: Saturday
- 7: Sunday
- 8: RF
- 9: DK
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q075
(In the last 7 days), how much time in total did you spend doing these activities that made you sweat at least a little and breathe harder?
Min = 0; Max = 168
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_N080
Enter number of minutes.
Min = 0; Max = 9995
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q095
You have reported a total of ^DV_PAATOTAL minutes of physical activity. Of these activities, were there any of vigorous intensity, meaning they caused you to be out of breath?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q100
In the last 7 days, how much time in total did you spend doing vigorous activities that caused you to be out of breath?
Min = 0; Max = 168
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_N105
Enter number of minutes.
Min = 0; Max = 9995
Physical activities for youth (PAY)
Physical activities for youth (PAY) - Question identifier:PAY_R001
The following questions are about various types of physical activities that you have done each day in the past week.
Physical activities for youth (PAY) - Question identifier:PAY_Q005
During the last 7 days, that is from last ^DT_DAYLASTWEEKE to yesterday, did you...?
- 1: Attend school
- 2: Attend a day camp
- 3: Attend paid or unpaid work
- 4: None of the above
- 8: RF
- 9: DK
Physical activities for youth (PAY) - Question identifier:PAY_Q010
In the last 7 days, did you use active ways like walking or cycling to get to places such as [school, the bus stop, the shopping centre, work] or to visit friends?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical activities for youth (PAY) - Question identifier:PAY_Q015
How much time did you spend using active ways to get to places...
...yesterday?
...on ^DT_DAY2DAYSAGOE?
...on ^DT_DAY3DAYSAGOE?
...on ^DT_DAY4DAYSAGOE?
...on ^DT_DAY5DAYSAGOE?
...on ^DT_DAY6DAYSAGOE?
...on ^DT_DAYLASTWEEKE?
Min = 0; Max = 10080
Physical activities for youth (PAY) - Question identifier:PAY_Q025
In the last 7 days, did you do sports, fitness or recreational physical activities while at [school or day camp, including during physical education classes, during your breaks and any other time you played indoors or outdoors]?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical activities for youth (PAY) - Question identifier:PAY_Q030
Did any of these activities make you sweat at least a little and breathe harder?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical activities for youth (PAY) - Question identifier:PAY_Q035
How much time did you spend doing these activities at [school or day camp] that made you sweat at least a little and breathe harder...
...yesterday?
...on ^DT_DAY2DAYSAGOE?
...on ^DT_DAY3DAYSAGOE?
...on ^DT_DAY4DAYSAGOE?
...on ^DT_DAY5DAYSAGOE?
...on ^DT_DAY6DAYSAGOE?
...on ^DT_DAYLASTWEEKE?
Min = 0; Max = 10080
Physical activities for youth (PAY) - Question identifier:PAY_Q045
In the last 7 days, did you do physical activities in your leisure time including exercising, playing an organized or non-organized sport or playing with your friends?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical activities for youth (PAY) - Question identifier:PAY_Q050
Did any of these leisure-time activities make you sweat at least a little and breathe harder?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical activities for youth (PAY) - Question identifier:PAY_Q055
How much time did you spend doing these leisure-time activities that made you sweat at least a little and breathe harder...
...yesterday?
...on ^DT_DAY2DAYSAGOE?
...on ^DT_DAY3DAYSAGOE?
...on ^DT_DAY4DAYSAGOE?
...on ^DT_DAY5DAYSAGOE?
...on ^DT_DAY6DAYSAGOE?
...on ^DT_DAYLASTWEEKE?
Min = 0; Max = 10080
Physical activities for youth (PAY) - Question identifier:PAY_Q065
In the last 7 days, did you do any other physical [activities that you have not already reported], for example, while you [were doing paid or unpaid work or] helping your family with chores?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical activities for youth (PAY) - Question identifier:PAY_Q070
Did any of these other physical activities make you sweat at least a little and breathe harder?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical activities for youth (PAY) - Question identifier:PAY_Q075
How much time did you spend doing these other physical activities that made you sweat at least a little and breathe harder...
...yesterday?
...on ^DT_DAY2DAYSAGOE?
...on ^DT_DAY3DAYSAGOE?
...on ^DT_DAY4DAYSAGOE?
...on ^DT_DAY5DAYSAGOE?
...on ^DT_DAY6DAYSAGOE?
...on ^DT_DAYLASTWEEKE?
Min = 0; Max = 10080
Physical activities for youth (PAY) - Question identifier:PAY_Q090
You have reported a total of [DV_PAYTRAVEL + DV_PAYSCHOOL + DV_PAYREC + DV_PAYOTHER] minutes of physical activity. Of these activities, were there any of vigorous intensity, meaning they caused you to be out of breath?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical activities for youth (PAY) - Question identifier:PAY_Q095
In the last 7 days, on which days did you do these vigorous activities that caused you to be out of breath?
- 1: Yesterday
- 2: ^DT_DAY2DAYSAGOE
- 3: ^DT_DAY3DAYSAGOE
- 4: ^DT_DAY4DAYSAGOE
- 5: ^DT_DAY5DAYSAGOE
- 6: ^DT_DAY6DAYSAGOE
- 7: ^DT_DAYLASTWEEKE
- 8: RF
- 9: DK
Physical activities for youth (PAY) - Question identifier:PAY_Q100
(In the last 7 days), how much time in total did you spend doing vigorous activities that caused you to be out of breath?
Min = 0; Max = 168
Physical activities for youth (PAY) - Question identifier:PAY_N105
Enter number of minutes.
Min = 0; Max = 9995
Use of protective equipment (UPE)
Use of protective equipment (UPE) - Question identifier:UPE_R005
Now a few questions about precautions you take while participating in some physical activities.
Use of protective equipment (UPE) - Question identifier:UPE_Q005
In the past 12 months, have you done any bicycling?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Use of protective equipment (UPE) - Question identifier:UPE_Q010
When riding a bicycle, how often do you wear a helmet?
- 1: Always
- 2: Most of the time
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Use of protective equipment (UPE) - Question identifier:UPE_Q015
In the past 12 months, have you done any in-line skating or rollerblading?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Use of protective equipment (UPE) - Question identifier:UPE_Q020
When in-line skating or rollerblading, how often do you wear a helmet?
- 1: Always
- 2: Most of the time
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Use of protective equipment (UPE) - Question identifier:UPE_Q025
How often do you wear wrist guards or wrist protectors?
- 1: Always
- 2: Most of the time
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Use of protective equipment (UPE) - Question identifier:UPE_Q030
(How often do you wear) elbow pads?
- 1: Always
- 2: Most of the time
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Use of protective equipment (UPE) - Question identifier:UPE_Q035
(How often do you wear) knee pads?
- 1: Always
- 2: Most of the time
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Use of protective equipment (UPE) - Question identifier:UPE_Q040
In the past 12 months, did you do...?
- 1: Downhill skiing only
- 2: Snowboarding only
- 3: Both
- 4: Neither
- 8: RF
- 9: DK
Use of protective equipment (UPE) - Question identifier:UPE_Q045
When downhill skiing, how often do you wear a helmet?
- 1: Always
- 2: Most of the time
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Use of protective equipment (UPE) - Question identifier:UPE_Q050
When snowboarding, how often do you wear a helmet?
- 1: Always
- 2: Most of the time
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Use of protective equipment (UPE) - Question identifier:UPE_Q055
(When snowboarding), how often do you wear wrist guards or wrist protectors?
- 1: Always
- 2: Most of the time
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Use of protective equipment (UPE) - Question identifier:UPE_Q060
In the past 12 months, have you done any skateboarding?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Use of protective equipment (UPE) - Question identifier:UPE_Q065
How often do you wear a helmet?
- 1: Always
- 2: Most of the time
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Use of protective equipment (UPE) - Question identifier:UPE_Q070
(How often do you wear) wrist guards or wrist protectors?
- 1: Always
- 2: Most of the time
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Use of protective equipment (UPE) - Question identifier:UPE_Q075
(How often do you wear) elbow pads?
- 1: Always
- 2: Most of the time
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Use of protective equipment (UPE) - Question identifier:UPE_Q080
In the past 12 months, have you played any ice hockey?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Use of protective equipment (UPE) - Question identifier:UPE_Q085
When playing ice hockey, how often do you wear a mouth guard?
- 1: Always
- 2: Most of the time
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Sun safety behaviours (SSB)
Sun safety behaviours (SSB) - Question identifier:SSB_R001
The next questions are about exposure to the sun and various sun behaviours.
Sun safety behaviours (SSB) - Question identifier:SSB_Q005
In the past 12 months, has any part of your body been sunburnt?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Sun safety behaviours (SSB) - Question identifier:SSB_R010
For the next questions, think about a typical weekend, or day off from work or school during the summer months.
Sun safety behaviours (SSB) - Question identifier:SSB_Q010
About how much time each day do you spend in the sun between 10 am and 4 pm?
- 1: None
- 2: Less than 30 minutes
- 3: 30 to 59 minutes
- 4: 1 hour to less than 2 hours
- 5: 2 hours to less than 3 hours
- 6: 3 hours to less than 4 hours
- 7: 4 hours to 6 hours
- 8: RF
- 9: DK
Sun safety behaviours (SSB) - Question identifier:SSB_Q015
In the summer months, on a typical weekend or day off, when you are in the sun for periods of 30 minutes or more, how often do you:
seek shade?
- 1: Always
- 2: Often
- 3: Sometimes
- 4: Rarely
- 5: Never
- 8: RF
- 9: DK
Sun safety behaviours (SSB) - Question identifier:SSB_Q020
(In the summer months, on a typical weekend or day off, when you are in the sun for 30 minutes or more, how often do you:)
wear a hat that shades your face, ears and neck?
- 1: Always
- 2: Often
- 3: Sometimes
- 4: Rarely
- 5: Never
- 8: RF
- 9: DK
Sun safety behaviours (SSB) - Question identifier:SSB_Q025
(In the summer months, on a typical weekend or day off, when you are in the sun for 30 minutes or more, how often do you:)
wear long [pants or a long skirt?]
- 1: Always
- 2: Often
- 3: Sometimes
- 4: Rarely
- 5: Never
- 8: RF
- 9: DK
Sun safety behaviours (SSB) - Question identifier:SSB_Q030
(In the summer months, on a typical weekend or day off, when you are in the sun for 30 minutes or more, how often do you:)
wear sunglasses?
- 1: Always
- 2: Often
- 3: Sometimes
- 4: Rarely
- 5: Never
- 8: RF
- 9: DK
Sun safety behaviours (SSB) - Question identifier:SSB_Q035
(In the summer months, on a typical weekend or day off, when you are in the sun for 30 minutes or more, how often do you:)
use sunscreen on your face?
- 1: Always
- 2: Often
- 3: Sometimes
- 4: Rarely
- 5: Never
- 8: RF
- 9: DK
Sun safety behaviours (SSB) - Question identifier:SSB_Q040
What Sun Protection Factor (SPF) do you usually use on your face?
- 1: Less than 15
- 2: 15 to 29
- 3: 30 to 44
- 4: 45 or higher
- 8: RF
- 9: DK
Sun safety behaviours (SSB) - Question identifier:SSB_Q045
In the summer months, on a typical weekend or day off, when you are in the sun for 30 minutes or more, how often do you:
use sunscreen on your body?
- 1: Always
- 2: Often
- 3: Sometimes
- 4: Rarely
- 5: Never
- 8: RF
- 9: DK
Sun safety behaviours (SSB) - Question identifier:SSB_Q050
What Sun Protection Factor (SPF) do you usually use on your body?
- 1: Less than 15
- 2: 15 to 29
- 3: 30 to 44
- 4: 45 or higher
- 8: RF
- 9: DK
Sun safety behaviours (SSB) - Question identifier:SSB_Q055
In the past 12 months, have you used a tanning bed or booth with tanning lamps?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Sun safety behaviours (SSB) - Question identifier:SSB_Q060
How often?
Min = 1; Max = 365
Sun safety behaviours (SSB) - Question identifier:SSB_N060A
Select the reporting period.
- 1: Per day
- 2: Per week
- 3: Per month
- 4: Per year
- 8: RF
- 9: DK
Sun safety behaviours (SSB) - Question identifier:SSB_Q065
What is the main reason that you use tanning beds or booths with lamps?
- 1: It is a safe way of getting a tan
- 2: To get a good base tan that will provide protection prior to sun exposure
- 3: To look good / obtain a healthy glow
- 4: To boost vitamin D intake
- 5: To treat a skin condition or for other medical reasons
- 6: Other
- 8: RF
- 9: DK
Sedentary activities (SAC)
Sedentary activities (SAC) - Question identifier:SAC_R001
Now, a few additional questions about activities you do in your leisure time, that is, activities not at work nor during class time nor during transportation.
Some of these activities may appear similar, but please only report your activity once.
Sedentary activities (SAC) - Question identifier:SAC_Q005
In the last 7 days, how much of your free time did you spend:
reading books, magazines or newspapers, including in electronic formats? Include time spent reading as part of your homework, but do not include time spent reading at work, during class time, during transportation or while exercising. Include Braille or audio books, for visually impaired.
Min = 0; Max = 95.0
Sedentary activities (SAC) - Question identifier:SAC_Q010
In the last 7 days, how much of your free time did you spend:
watching TV, DVDs, movies or Internet videos? Please do not include time spent watching while exercising.
Min = 0; Max = 95.0
Sedentary activities (SAC) - Question identifier:SAC_Q015
(In the last 7 days, how much of your free time did you spend):
playing video games that require physical activity, such as Wii Fit, Xbox Kinect or the game "Just Dance"?
Min = 0; Max = 168.0
Sedentary activities (SAC) - Question identifier:SAC_Q020
(In the last 7 days, how much of your free time did you spend):
playing other video or computer games? Include games played on a game console, computer or hand-held electronic device such as a tablet or smart phone.
Min = 0; Max = 95.0
Sedentary activities (SAC) - Question identifier:SAC_Q025
[Excluding the activities you have already reported, in] the last 7 days, how much of your free time did you spend on a computer, tablet or smart phone, doing activities such as surfing the Internet, emailing, using Facebook or doing homework?
Do not include time spent at work, during class time or during transportation.
Min = 0; Max = 95.0
Maternal experiences (MEX)
Maternal experiences (MEX) - Question identifier:MEX_R001
The next questions are specific to women's health.
Maternal experiences (MEX) - Question identifier:MEX_Q005
Are you taking a vitamin supplement containing folic acid?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q010
Have you given birth in the past 5 years?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q015
What is the name of your last born child?
Long Answer Length = 50
Maternal experiences (MEX) - Question identifier:MEX_Q020
What is [your last child]'s date of birth?
Min = 1; Max = 31
Maternal experiences (MEX) - Question identifier:MEX_Q025
(What is [your last child]'s date of birth?)
- 01: January
- 02: February
- 03: March
- 04: April
- 05: May
- 06: June
- 07: July
- 08: August
- 09: September
- 10: October
- 11: November
- 12: December
- 98: RF
- 99: DK
Maternal experiences (MEX) - Question identifier:MEX_Q030
(What is [your last child]'s date of birth?)
Min = 2010; Max = 2099
Maternal experiences (MEX) - Question identifier:MEX_R040
The next questions are about your maternal experiences related to [your last child].
Maternal experiences (MEX) - Question identifier:MEX_Q040
In the three months before you got pregnant with [your last child], did you take a folic acid supplement or a multivitamin containing folic acid?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q045
Did you take it every day or almost every day?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q050
During the first three months of your pregnancy (with [your last child]), did you take a folic acid supplement or a multivitamin containing folic acid?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q055
Did you take it every day or almost every day?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q060
Before your pregnancy (with [your last child]), were you aware that taking folic acid before becoming pregnant can help prevent some birth defects?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q065
During your pregnancy (with [your last child]), did you take a vitamin supplement containing iron?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q070
Just before your pregnancy (with [your last child]), how much did you weigh?
Min = 1; Max = 700
Maternal experiences (MEX) - Question identifier:MEX_N075
Was that in pounds or kilograms?
- 1: Pounds
- 2: Kilograms
Maternal experiences (MEX) - Question identifier:MEX_Q080
How much weight did you gain during that pregnancy?
Min = -50; Max = 199
Maternal experiences (MEX) - Question identifier:MEX_N085
Was that in pounds or kilograms?
- 1: Pounds
- 2: Kilograms
Maternal experiences (MEX) - Question identifier:MEX_Q090
[How often does [your last child]/When [your last child] was less than one year old, how often did he/she] sleep in the same bed with you or anyone else?
- 1: Every day or almost every day
- 2: Once or twice a week
- 3: A few times a month
- 4: Less than once a month
- 5: Never
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q095
What is the main reason that [your last child] [is/was] sleeping in the same bed with you or someone else?
- 1: To breastfeed
- 2: So the baby would sleep / So I could get some sleep
- 3: Did not have room for a crib
- 4: Could not afford a crib
- 5: Believe that bedsharing was best for my child
- 6: Child was sick
- 7: Other
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q100
Was [your last child] breastfed or given breast milk even for a short time?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q105
What is the main reason that you did not breastfeed or give breast milk?
- 1: Bottle feeding is easier
- 2: Formula is as good as breast milk
- 3: Breastfeeding is unappealing
- 4: Medical condition - mother
- 5: Other - Specify
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q110
Are you still breastfeeding or giving breast milk to [your last child]?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q115
How long did you breastfeed or give breast milk to [your last child]?
Min = 1; Max = 365
Maternal experiences (MEX) - Question identifier:MEX_N115A
Was this time in days, weeks, months or years?
If respondent reports less than 1 year but with a fraction, round the amount up. For example, 3 and ½ months would become 4 months.
If the respondent reports more than a year, with half values, report in months. For example, 2 ½ years = 30 months.
- 1: Days
- 2: Weeks
- 3: Months
- 4: Years
Maternal experiences (MEX) - Question identifier:MEX_Q120
What is the main reason that you stopped breastfeeding or giving breast milk?
- 01: Not enough breast milk
- 02: Baby was ready for solid foods
- 03: Inconvenience / fatigue due to breastfeeding
- 04: Difficulty with breastfeeding (e.g., sore nipples, engorged breasts, mastitis)
- 05: Medical condition - mother
- 06: Medical condition - baby
- 07: Planned to stop at this time
- 08: Child weaned him / herself (e.g., baby refusing breast, lack of interest)
- 09: Returned to work / school
- 10: Other - Specify
- 98: RF
- 99: DK
Maternal experiences (MEX) - Question identifier:MEX_Q125
[Are you giving [your last child] a vitamin D supplement?/When [your last child] was less than a year old, did you give him/her a vitamin D supplement?/When [your last child] was less than one year old and fed breast milk, did you give him/her a vitamin D supplement?/When [your last child] was fed breast milk, did you give him/her a vitamin D supplement?]
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q130
[Now that [your last child] is more than a year old, are you still giving him/her a vitamin D supplement?/When [your last child] was older than one and fed breast milk, did you continue to give him/her a vitamin D supplement?]
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q140
Overall, how often [do/did] you give [your last child] a supplement containing vitamin D?
- 1: Every day
- 2: Almost every day
- 3: Once or twice a week
- 4: Less than once a week
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q150
[While you were still breastfeeding, had/Have] liquids such as milk, formula, water, juice, tea or herbal mixture been introduced to [your last child]'s feeds?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q155
How old was [your last child] when other liquids were first added to the feeds?
Min = 1; Max = 365
Maternal experiences (MEX) - Question identifier:MEX_N160
Was this time in days, weeks, months or years?
If respondent reports less than 1 year but with a fraction, round the amount up. For example, 3 and ½ months would become 4 months.
If the respondent reports more than a year, with half values, report in months. For example, 2 ½ years = 30 months.
- 1: Days
- 2: Weeks
- 3: Months
- 4: Years
Maternal experiences (MEX) - Question identifier:MEX_Q170
Have solid foods such as cereals, mashed up or pureed meat, vegetables or fruits been introduced to the baby's feeds?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q175
How old was [your last child] when solid foods (such as cereals, mashed up or pureed meat, vegetables or fruits) were first added to their feeds?
Min = 1; Max = 365
Maternal experiences (MEX) - Question identifier:MEX_N180
Was this time in days, weeks, months or years?
If respondent reports less than 1 year but with a fraction, round the amount up. For example, 3 and ½ months would become 4 months.
If the respondent reports more than a year, with half values, report in months. For example, 2 ½ years = 30 months.
- 1: Days
- 2: Weeks
- 3: Months
- 4: Years
Maternal experiences (MEX) - Question identifier:MEX_Q190
What was the first solid food added to ^BABYSNAME's feeds?
- 1: Infant cereals
- 2: Meat, fish or poultry
- 3: Meat alternatives (includes eggs, tofu, legumes, peas or lentils)
- 4: Fruits or vegetables
- 5: Other
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q195
What is the main reason [other liquids/solid foods/other liquids and solid foods] were first added to [your last child]'s feeds?
- 01: Not enough breast milk
- 02: [Baby was ready for solid foods/null]
- 03: Inconvenience / fatigue due to breastfeeding
- 04: Difficulty with breastfeeding (e.g., sore nipples, engorged breasts, mastitis)
- 05: Medical condition - mother
- 06: Medical condition - baby
- 07: Advice from health professional / family
- 08: Returned to work / school
- 09: Formula equally healthy for baby
- 10: Other - Specify
- 98: RF
- 99: DK
Smoking during maternal experience (MXS)
Smoking during maternal experience (MXS) - Question identifier:MXS_Q005
In the three months before your pregnancy with ^DT_BABYSNAME, or before you realized you were pregnant, did you smoke cigarettes?
- 1: Everyday
- 2: Almost everyday
- 3: About 2 or 3 times a week
- 4: About once a week
- 5: Once or twice
- 6: Never
- 8: RF
- 9: DK
Smoking during maternal experience (MXS) - Question identifier:MXS_Q010
Once you found out you were pregnant (with ^DT_BABYSNAME), did you smoke?
- 1: Everyday
- 2: Almost everyday
- 3: About 2 or 3 times a week
- 4: About once a week
- 5: Once or twice
- 6: Never
- 8: RF
- 9: DK
Smoking during maternal experience (MXS) - Question identifier:MXS_Q015
During the last 3 months of your pregnancy (with ^DT_BABYSNAME), did you smoke?
- 1: Everyday
- 2: Almost everyday
- 3: About 2 or 3 times a week
- 4: About once a week
- 5: Once or twice
- 6: Never
- 8: RF
- 9: DK
Smoking during maternal experience (MXS) - Question identifier:MXS_Q020
Did anyone regularly smoke in your presence during your pregnancy with ^DT_BABYSNAME?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Alcohol use during maternal experience (MXA)
Alcohol use during maternal experience (MXA) - Question identifier:MXA_Q005
In the three months before your pregnancy with ^DT_BABYSNAME, or before you realized you were pregnant, did you drink any alcohol?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Alcohol use during maternal experience (MXA) - Question identifier:MXA_Q010
How often did you drink?
- 1: Less than once per month
- 2: Once per month
- 3: 2 to 3 times per month
- 4: Once a week
- 5: 2 to 3 times per week
- 6: 4 to 6 times per week
- 7: Everyday
- 8: RF
- 9: DK
Alcohol use during maternal experience (MXA) - Question identifier:MXA_Q015
Once you found out you were pregnant with ^DT_BABYSNAME, did you drink any alcohol?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Alcohol use during maternal experience (MXA) - Question identifier:MXA_Q020
How often did you drink?
- 1: Less than once per month
- 2: Once per month
- 3: 2 to 3 times per month
- 4: Once a week
- 5: 2 to 3 times per week
- 6: 4 to 6 times per week
- 7: Everyday
- 8: RF
- 9: DK
Alcohol use during maternal experience (MXA) - Question identifier:MXA_Q025
During the last 3 months of your pregnancy (with ^DT_BABYSNAME), did you drink any alcohol?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Alcohol use during maternal experience (MXA) - Question identifier:MXA_Q030
How often did you drink?
- 1: Less than once per month
- 2: Once per month
- 3: 2 to 3 times per month
- 4: Once a week
- 5: 2 to 3 times per week
- 6: 4 to 6 times per week
- 7: Everyday
- 8: RF
- 9: DK
Alcohol use during maternal experience (MXA) - Question identifier:MXA_Q035
While you were breastfeeding (^DT_BABYSNAME), did you drink any alcohol?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Alcohol use during maternal experience (MXA) - Question identifier:MXA_Q040
How often did you drink?
- 1: Less than once per month
- 2: Once per month
- 3: 2 to 3 times per month
- 4: Once a week
- 5: 2 to 3 times per week
- 6: 4 to 6 times per week
- 7: Everyday
- 8: RF
- 9: DK
Driving and safety (DRV)
Driving and safety (DRV) - Question identifier:DRV_R001
The next questions are about the use of a motor vehicle.
Driving and safety (DRV) - Question identifier:DRV_Q005
In the past 12 months, excluding motorcycles and off-road vehicles, have you driven a motor vehicle such as a car, truck or a van?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Driving and safety (DRV) - Question identifier:DRV_Q010
In the past 12 months, how often did you use a hands-free device such as Bluetooth when talking on the cell phone while driving a motor vehicle?
- 1: Often
- 2: Sometimes
- 3: Rarely
- 4: Never
- 5: Does not possess or have access to a cell phone
- 8: RF
- 9: DK
Driving and safety (DRV) - Question identifier:DRV_Q015
In the past 12 months, excluding hands-free use, how often did you talk on a cell phone while driving a motor vehicle?
- 1: Often
- 2: Sometimes
- 3: Rarely
- 4: Never
- 5: Does not possess or have access to a cell phone
- 8: RF
- 9: DK
Driving and safety (DRV) - Question identifier:DRV_Q020
In the past 12 months, how often did you text on a cell phone while driving a motor vehicle?
- 1: Often
- 2: Sometimes
- 3: Rarely
- 4: Never
- 5: Does not possess or have access to a cell phone
- 8: RF
- 9: DK
Driving and safety (DRV) - Question identifier:DRV_Q025
In the past 12 months, how often did you use a cell phone for any other reason while driving a motor vehicle, for example, to send or receive emails, use social media, look at maps, etc.?
- 1: Often
- 2: Sometimes
- 3: Rarely
- 4: Never
- 5: Does not possess or have access to a cell phone
- 8: RF
- 9: DK
Driving and safety (DRV) - Question identifier:DRV_Q030
In the past 12 months, have you driven a motorcycle?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Driving and safety (DRV) - Question identifier:DRV_Q035
In the past 12 months, how often did you [drive any vehicle] when you were feeling tired?
- 1: Often
- 2: Sometimes
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Driving and safety (DRV) - Question identifier:DRV_R040
The next few questions are about substance use while driving. Please be assured that anything you say will remain confidential.
Driving and safety (DRV) - Question identifier:DRV_Q040
In the past 12 months, have you driven a motor vehicle after having 2 or more drinks in the hour before you drove?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Driving and safety (DRV) - Question identifier:DRV_Q045
How many times (in the past 12 months)?
Min = 1; Max = 95
Driving and safety (DRV) - Question identifier:DRV_Q050
In the past 12 months, have you driven a motor vehicle under the influence of an illicit substance such as marijuana or hashish?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Driving and safety (DRV) - Question identifier:DRV_Q055
How many times (in the past 12 months)?
Min = 1; Max = 95
Driving and safety (DRV) - Question identifier:DRV_R060
Now some questions about driving leisure vehicles and being a passenger in different vehicles.
Driving and safety (DRV) - Question identifier:DRV_Q060
In the past 12 months, have you been a passenger with a driver who had 2 or more drinks in the hour before driving?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Driving and safety (DRV) - Question identifier:DRV_Q065
How many times (in the past 12 months)?
Min = 1; Max = 95
Driving and safety (DRV) - Question identifier:DRV_Q070
In the past 12 months, have you been the driver of, or a passenger on, an ATV (all-terrain vehicle) or a snowmobile?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Driving and safety (DRV) - Question identifier:DRV_Q075
How often do you wear a helmet when on an ATV or a snowmobile?
- 1: Always
- 2: Most of the time
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Driving and safety (DRV) - Question identifier:DRV_Q080
In the past 12 months, have you driven an ATV or snowmobile after having 2 or more drinks in the hour before you drove?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Driving and safety (DRV) - Question identifier:DRV_Q085
How many times (in the past 12 months)?
Min = 1; Max = 95
Driving and safety (DRV) - Question identifier:DRV_Q090
In the past 12 months, have you driven an ATV or snowmobile under the influence of an illlicit substance such as marijuana or hashish?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Driving and safety (DRV) - Question identifier:DRV_Q095
How many times (in the past 12 months)?
Min = 1; Max = 95
Driving and safety (DRV) - Question identifier:DRV_Q100
In the past 12 months, have you been a passenger on an ATV or snowmobile with a driver who had 2 or more drinks in the hour before driving?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Driving and safety (DRV) - Question identifier:DRV_Q105
How many times (in the past 12 months)?
Min = 1; Max = 95
Flu shots (FLU)
Flu shots (FLU) - Question identifier:FLU_R001
Now a few questions about your use of various health care services.
Flu shots (FLU) - Question identifier:FLU_Q005
Have you ever had a seasonal flu shot, excluding the H1N1 flu shot?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Flu shots (FLU) - Question identifier:FLU_Q010
When did you have your last seasonal flu shot?
- 1: Less than 1 year ago
- 2: 1 year to less than 2 years ago
- 3: 2 years ago or more
- 8: RF
- 9: DK
Flu shots (FLU) - Question identifier:FLU_Q015
In which month did you have your last seasonal flu shot?
- 01: January
- 02: February
- 03: March
- 04: April
- 05: May
- 06: June
- 07: July
- 08: August
- 09: September
- 10: October
- 11: November
- 12: December
- 98: RF
- 99: DK
Flu shots (FLU) - Question identifier:FLU_Q020
Was that this year or last year?
- 1: This year
- 2: Last year
- 8: RF
- 9: DK
Flu shots (FLU) - Question identifier:FLU_Q025
What are the reasons that you have not had a seasonal flu shot in the past year?
- 01: Lack of time
- 02: Respondent - did not think it was necessary
- 03: Doctor - did not think it was necessary
- 04: Not available - at time required
- 05: Did not know where to go / uninformed
- 06: Feelings of fear or discomfort
- 07: Bad reaction to previous flu shot
- 08: Bad reaction to previous vaccine other than flu shot
- 09: Unsure of / does not believe in benefits of vaccine
- 10: Does not want vaccine for fear of what it contains
- 11: Other
- 98: RF
- 99: DK
Physical check-up (PCU)
Physical check-up (PCU) - Question identifier:PCU_R001
Next, I would like to ask you some questions related to general physical check-ups. Please, do not include check-ups you may have had during a visit for a specific health [problem or during a pregnancy].
Physical check-up (PCU) - Question identifier:PCU_Q005
Have you ever had a general physical check-up?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical check-up (PCU) - Question identifier:PCU_Q010
How often do you usually have a general physical check-up?
- 1: More than once a year
- 2: Once a year
- 3: Once every 2 years
- 4: Once every 3 years
- 5: Less than once every 3 years
- 6: No regular pattern
- 8: RF
- 9: DK
Physical check-up (PCU) - Question identifier:PCU_Q015
When was the last time?
- 1: 1 year or less
- 2: More than 1 year to 2 years ago
- 3: More than 2 years to 3 years ago
- 4: More than 3 years to 5 years ago
- 5: More than 5 years ago
- 8: RF
- 9: DK
Physical check-up (PCU) - Question identifier:PCU_Q020
What are the reasons that you have not had a general physical check-up in the past 3 years?
- 1: Don't have a doctor
- 2: Lack of time
- 3: Respondent did not think it was necessary
- 4: Doctor did not think it was necessary
- 5: Feelings of fear or discomfort
- 6: Other
- 8: RF
- 9: DK
Physical check-up (PCU) - Question identifier:PCU_Q025
During your last general physical check-up, did a health professional:
weigh you?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical check-up (PCU) - Question identifier:PCU_Q030
(During your last general physical check-up, did a health professional:)
measure your height?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical check-up (PCU) - Question identifier:PCU_Q035
(During your last general physical check-up, did a health professional:)
check your blood pressure?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical check-up (PCU) - Question identifier:PCU_Q040
(During your last general physical check-up, did a health professional:)
discuss with you any risks that your weight might pose to your health?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical check-up (PCU) - Question identifier:PCU_Q045
(During your last general physical check-up, did a health professional:)
recommend that your level of cholesterol be tested?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Blood pressure check (BPC)
Blood pressure check (BPC) - Question identifier:BPC_R001
Now, a few questions about blood pressure measurement.
Blood pressure check (BPC) - Question identifier:BPC_Q005
Have you ever had your blood pressure measured by a health professional?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Blood pressure check (BPC) - Question identifier:BPC_Q010
When was the last time you had your blood pressure measured (by a health professional)?
- 1: Less than 1 year to 1 year ago
- 2: More than 1 year to 2 years ago
- 3: More than 2 years to 3 years ago
- 4: More than 3 years to 5 years ago
- 5: More than 5 years ago
- 8: RF
- 9: DK
Blood pressure check (BPC) - Question identifier:BPC_Q015
What are the reasons that you have not had your blood pressure measured (by a health professional) in the past 2 years?
- 1: Lack of time
- 2: Respondent did not think it was necessary
- 3: Doctor did not think it was necessary
- 4: Feelings of fear or discomfort
- 5: Don't have a doctor
- 6: Other
- 8: RF
- 9: DK
Blood pressure check (BPC) - Question identifier:BPC_Q020
Were you pregnant the last time your blood pressure was measured (by a health professional)?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Pap smear test (PAP)
Pap smear test (PAP) - Question identifier:PAP_Q005
Have you ever had a PAP smear test?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Pap smear test (PAP) - Question identifier:PAP_Q010
When was the last time?
- 1: Less than 1 year to 1 year ago
- 2: More than 1 year to 2 years ago
- 3: More than 2 years to 3 years ago
- 4: More than 3 years to 5 years ago
- 5: More than 5 years ago
- 8: RF
- 9: DK
Pap smear test (PAP) - Question identifier:PAP_Q015
What are the reasons that you have not had a PAP smear test in the past 3 years?
- 1: Lack of time
- 2: Respondent did not think it was necessary
- 3: Doctor did not think it was necessary
- 4: Feelings of fear or discomfort
- 5: Don't have a doctor
- 6: [Had a complete hysterectomy]
- 7: Other
- 8: RF
- 9: DK
Mammography (MAM)
Mammography (MAM) - Question identifier:MAM_Q005
Have you ever had a mammogram, that is, a breast x-ray?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Mammography (MAM) - Question identifier:MAM_Q010
When was the last time?
- 1: Less than 1 year to 1 year ago
- 2: More than 1 year to 2 years ago
- 3: More than 2 years to 3 years ago
- 4: More than 3 years to 5 years ago
- 5: More than 5 years ago
- 8: RF
- 9: DK
Mammography (MAM) - Question identifier:MAM_Q015
What are the reasons you have not had a mammogram in the past 3 years?
- 1: Lack of time
- 2: Respondent did not think it was necessary
- 3: Doctor did not think it was necessary
- 4: Feelings of fear or discomfort
- 5: Don't have a doctor
- 6: Had a bilateral mastectomy (both breasts were removed)
- 7: Other
- 8: RF
- 9: DK
Prostate cancer screening (PSA)
Prostate cancer screening (PSA) - Question identifier:PSA_R001
Now, a few questions related to prostate exams.
Prostate cancer screening (PSA) - Question identifier:PSA_Q005
Have you ever had a prostate specific antigen test for prostate cancer, that is, a PSA blood test?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Prostate cancer screening (PSA) - Question identifier:PSA_Q010
When was the last time?
- 1: Less than 1 year to 1 year ago
- 2: More than 1 year to 2 years ago
- 3: More than 2 years to 3 years ago
- 4: More than 3 years to 5 years ago
- 5: More than 5 years ago
- 8: RF
- 9: DK
Prostate cancer screening (PSA) - Question identifier:PSA_Q015
Why did you have it?
- 1: Family history of prostate cancer
- 2: Part of regular check-up / routine screening
- 3: Age
- 4: Race
- 5: Follow-up of problem
- 6: Follow-up of prostate cancer treatment
- 7: Other
- 8: RF
- 9: DK
Prostate cancer screening (PSA) - Question identifier:PSA_Q020
A Digital Rectal Exam is an exam in which a gloved finger is inserted into the rectum in order to feel the prostate gland.
Have you ever had this exam?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Prostate cancer screening (PSA) - Question identifier:PSA_Q025
When was the last time?
- 1: Less than 1 year to 1 year ago
- 2: More than 1 year to 2 years ago
- 3: More than 2 years to 3 years ago
- 4: More than 3 years to 5 years ago
- 5: More than 5 years ago
- 8: RF
- 9: DK
Colorectal cancer screening (CCS)
Colorectal cancer screening (CCS) - Question identifier:CCS_R001
Now a few questions about various colorectal exams.
Colorectal cancer screening (CCS) - Question identifier:CCS_Q005
An FOBT is a test to check for blood in your stool, where you have a bowel movement and use a stick to smear a small sample on a special card.
Have you ever had this test?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Colorectal cancer screening (CCS) - Question identifier:CCS_Q010
When was the last time?
- 1: Less than 1 year to 1 year ago
- 2: More than 1 year to 2 years ago
- 3: More than 2 years to 3 years ago
- 4: More than 3 years to 5 years ago
- 5: More than 5 years ago
- 8: RF
- 9: DK
Colorectal cancer screening (CCS) - Question identifier:CCS_Q015
What are the reasons you have not had a FOBT test in the past 2 years?
- 1: Lack of time
- 2: Respondent did not think it was necessary
- 3: Doctor did not think it was necessary
- 4: Feelings of fear or discomfort
- 5: Don't have a doctor
- 6: Had a colonoscopy instead
- 7: Other
- 8: RF
- 9: DK
Colorectal cancer screening (CCS) - Question identifier:CCS_Q020
A colonoscopy or sigmoidoscopy is a test where a tube is inserted into the rectum to view the bowel for early signs of cancer and other health problems. Have you ever had either of these exams?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Colorectal cancer screening (CCS) - Question identifier:CCS_Q025
When was the last time you had a colonoscopy or sigmoidoscopy?
- 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 to 7 years ago
- 6: More than 7 years ago
- 8: RF
- 9: DK
Colorectal cancer screening (CCS) - Question identifier:CCS_Q030
What are the reasons you have not had this test in the past 5 years?
- 1: Lack of time
- 2: Respondent did not think it was necessary
- 3: Doctor did not think it was necessary
- 4: Feelings of fear or discomfort
- 5: Don't have a doctor
- 6: Other
- 8: RF
- 9: DK
Colorectal cancer screening (CCS) - Question identifier:CCS_Q035
Was the colonoscopy or sigmoidoscopy a follow-up of the results of an FOBT?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Spirometry (SPI)
Spirometry (SPI) - Question identifier:SPI_Q005
Spirometry is a common lung function test that consists of blowing into a small tube attached to a machine.
Have you ever had this test?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Spirometry (SPI) - Question identifier:SPI_Q010
When was the last time?
- 1: Less than 6 months ago
- 2: 6 months to less than 1 year ago
- 3: 1 year to less than 2 years ago
- 4: 2 years to less than 5 years ago
- 5: 5 or more years ago
- 8: RF
- 9: DK
Diabetes care (DIA)
Diabetes care (DIA) - Question identifier:DIA_R001
You reported earlier that you have diabetes. The following questions are about diabetes care.
Diabetes care (DIA) - Question identifier:DIA_Q005
In the past 12 months, has a health care professional tested you for haemoglobin "A-one-C"? (An "A-one-C" haemoglobin test measures the average level of blood sugar over a 3-month period.)
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Diabetes care (DIA) - Question identifier:DIA_Q010
How many times? (In the past 12 months, has a health care professional tested you for haemoglobin "A-one-C"?)
Min = 1; Max = 99
Diabetes care (DIA) - Question identifier:DIA_Q015
In the past 12 months, has a health care professional checked your feet for any sores or irritations?
- 1: Yes
- 2: No
- 3: No feet
- 8: RF
- 9: DK
Diabetes care (DIA) - Question identifier:DIA_Q020
How many times? (In the past 12 months, has a health care professional checked your feet for any sores or irritations?)
Min = 1; Max = 99
Diabetes care (DIA) - Question identifier:DIA_Q025
In the past 12 months, has a health care professional tested your urine for protein (i.e., Microalbumin)?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Diabetes care (DIA) - Question identifier:DIA_Q030
Have you ever had an eye exam where the pupils of your eyes were dilated? (This procedure would have made you temporarily sensitive to light.)
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Diabetes care (DIA) - Question identifier:DIA_Q035
When was the last time?
- 1: Less than 1 year ago
- 2: 1 year to less than 2 years ago
- 3: 2 or more years ago
- 8: RF
- 9: DK
Diabetes care (DIA) - Question identifier:DIA_Q040
In the past 12 months, has a dietitian provided you with nutrition therapy adapted for people with diabetes? Please exclude advice received by a nurse.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Diabetes care (DIA) - Question identifier:DIA_R045
Now, some questions about diabetes care not provided by a health care professional.
Diabetes care (DIA) - Question identifier:DIA_Q045
How often do you usually have your blood checked for glucose or sugar by yourself or by a family member or friend?
Min = 0; Max = 365
Diabetes care (DIA) - Question identifier:DIA_N045A
Select the reporting period.
- 1: Per day
- 2: Per week
- 3: Per month
- 4: Per year
Diabetes care (DIA) - Question identifier:DIA_Q050
How often do you usually have your feet checked for any sores or irritations by yourself or by a family member or friend?
Min = 0; Max = 365
Diabetes care (DIA) - Question identifier:DIA_N050A
Select the reporting period.
- 1: Per day
- 2: Per week
- 3: Per month
- 4: Per year
Diabetes care (DIA) - Question identifier:DIA_R055
Now, a few questions about medication.
Diabetes care (DIA) - Question identifier:DIA_Q055
In the past month, have you taken any medicine for high blood pressure?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Diabetes care (DIA) - Question identifier:DIA_Q060
In the past month, have you taken any medicine for high blood cholesterol or lipids?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Eye examinations (EYX)
Eye examinations (EYX) - Question identifier:EYX_R001
Now, some questions about the health and care of your eyes.
Eye examinations (EYX) - Question identifier:EYX_Q005
Do you have insurance that covers all or part of the cost of eye glasses or contact lenses?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Eye examinations (EYX) - Question identifier:EYX_Q010
Is it...?
- 1: A government-sponsored plan
- 2: An employer-sponsored benefit plan
- 3: A plan sponsored through an association such as a union, trade association or student organization
- 4: Another plan, such as your own private plan purchased from an insurance company
- 8: RF
- 9: DK
Eye examinations (EYX) - Question identifier:EYX_Q015
In the past 12 months, have you seen an optometrist or ophthalmologist?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Eye examinations (EYX) - Question identifier:EYX_Q020
When did you last have an eye examination?
- 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
- 6: Never
- 8: RF
- 9: DK
Eye examinations (EYX) - Question identifier:EYX_Q025
What are the reasons that you have not had an eye examination in the past [2 years/year]?
- 1: Lack of time
- 2: Respondent - did not think it was necessary
- 3: Cost
- 4: Optometrist / Ophthalmologist - did not think it was necessary
- 5: Feelings of fear or discomfort
- 6: Don't have an optometrist or ophthalmologist
- 7: Other
- 8: RF
- 9: DK
Eye examinations (EYX) - Question identifier:EYX_Q030
Do you have cataracts?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Eye examinations (EYX) - Question identifier:EYX_Q035
Do you have glaucoma?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Consultations about mental health (CMH)
Consultations about mental health (CMH) - Question identifier:CMH_R001
Now I would like to ask you some questions about mental and emotional well-being.
Consultations about mental health (CMH) - Question identifier:CMH_Q005
In the past 12 months, that is, from [CURRENTDATE - 1] to yesterday, have you seen or talked to a health professional about your emotional or mental health?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Consultations about mental health (CMH) - Question identifier:CMH_Q010
How many times (in the past 12 months)?
Min = 1; Max = 366
Consultations about mental health (CMH) - Question identifier:CMH_Q015
Whom did you see or talk to?
- 1: Family doctor or general practitioner
- 2: Psychiatrist
- 3: Psychologist
- 4: Nurse
- 5: Social worker or counsellor
- 6: Other - Specify
- 8: RF
- 9: DK
Satisfaction with life (SWL)
Satisfaction with life (SWL) - Question identifier:SWL_R001
Now, I'd like to ask about your satisfaction with various aspects of your life. For each question, please tell me whether you are very satisfied, satisfied, neither satisfied nor dissatisfied, dissatisfied or very dissatisfied.
Satisfaction with life (SWL) - Question identifier:SWL_Q005
How satisfied are you with your job or main activity?
- 1: Very satisfied
- 2: Satisfied
- 3: Neither satisfied nor dissatisfied
- 4: Dissatisfied
- 5: Very dissatisfied
- 8: RF
- 9: DK
Satisfaction with life (SWL) - Question identifier:SWL_Q010
How satisfied are you with your leisure activities?
- 1: Very satisfied
- 2: Satisfied
- 3: Neither satisfied nor dissatisfied
- 4: Dissatisfied
- 5: Very dissatisfied
- 8: RF
- 9: DK
Satisfaction with life (SWL) - Question identifier:SWL_Q015
(How satisfied are you) with your financial situation?
- 1: Very satisfied
- 2: Satisfied
- 3: Neither satisfied nor dissatisfied
- 4: Dissatisfied
- 5: Very dissatisfied
- 8: RF
- 9: DK
Satisfaction with life (SWL) - Question identifier:SWL_Q020
(How satisfied are you) with yourself?
- 1: Very satisfied
- 2: Satisfied
- 3: Neither satisfied nor dissatisfied
- 4: Dissatisfied
- 5: Very dissatisfied
- 8: RF
- 9: DK
Satisfaction with life (SWL) - Question identifier:SWL_Q025
How satisfied are you with the way your body looks?
- 1: Very satisfied
- 2: Satisfied
- 3: Neither satisfied nor dissatisfied
- 4: Dissatisfied
- 5: Very dissatisfied
- 8: RF
- 9: DK
Satisfaction with life (SWL) - Question identifier:SWL_Q030
(How satisfied are you) with your relationships with family members?
- 1: Very satisfied
- 2: Satisfied
- 3: Neither satisfied nor dissatisfied
- 4: Dissatisfied
- 5: Very dissatisfied
- 8: RF
- 9: DK
Satisfaction with life (SWL) - Question identifier:SWL_Q035
(How satisfied are you) with your relationships with friends?
- 1: Very satisfied
- 2: Satisfied
- 3: Neither satisfied nor dissatisfied
- 4: Dissatisfied
- 5: Very dissatisfied
- 8: RF
- 9: DK
Satisfaction with life (SWL) - Question identifier:SWL_Q040
How satisfied are you with your housing?
- 1: Very satisfied
- 2: Satisfied
- 3: Neither satisfied nor dissatisfied
- 4: Dissatisfied
- 5: Very dissatisfied
- 8: RF
- 9: DK
Satisfaction with life (SWL) - Question identifier:SWL_Q045
(How satisfied are you) with your neighbourhood?
- 1: Very satisfied
- 2: Satisfied
- 3: Neither satisfied nor dissatisfied
- 4: Dissatisfied
- 5: Very dissatisfied
- 8: RF
- 9: DK
Depression (DEP)
Depression (DEP) - Question identifier:DEP_R001
The following questions deal with problems you may have had during the last two weeks.
Depression (DEP) - Question identifier:DEP_Q005
Over the last two weeks, how often have you:
had little interest or pleasure in doing things?
- 1: Not at all
- 2: Several days
- 3: More than half the days
- 4: Nearly every day
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q010
Over the last two weeks, how often have you:
felt down, depressed, or hopeless?
- 1: Not at all
- 2: Several days
- 3: More than half the days
- 4: Nearly every day
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q015
(Over the last two weeks, how often have you:)
had trouble falling or staying asleep, or sleeping too much?
- 1: Not at all
- 2: Several days
- 3: More than half the days
- 4: Nearly every day
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q020
(Over the last two weeks, how often have you:)
felt tired or had little energy?
- 1: Not at all
- 2: Several days
- 3: More than half the days
- 4: Nearly every day
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q025
Over the last two weeks, how often have you:
had poor appetite or overate?
- 1: Not at all
- 2: Several days
- 3: More than half the days
- 4: Nearly every day
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q030
(Over the last two weeks, how often have you:)
felt bad about yourself, or that you are a failure or have let yourself or your family down?
- 1: Not at all
- 2: Several days
- 3: More than half the days
- 4: Nearly every day
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q035
(Over the last two weeks, how often have you:)
had trouble concentrating on things, such as reading the newspaper or watching television?
- 1: Not at all
- 2: Several days
- 3: More than half the days
- 4: Nearly every day
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q040
Over the last two weeks, how often have you:
been moving or speaking so slowly that other people could have noticed? Or the opposite, being so fidgety or restless that you have been moving around a lot more than usual?
- 1: Not at all
- 2: Several days
- 3: More than half the days
- 4: Nearly every day
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q045
(Over the last two weeks, how often have you:)
had thoughts that you would be better off dead, or of hurting yourself?
- 1: Not at all
- 2: Several days
- 3: More than half the days
- 4: Nearly every day
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q050
How difficult have these problems made it for you to do your work, take care of things at home, or get along with other people?
- 1: Not difficult at all
- 2: Somewhat difficult
- 3: Very difficult
- 4: Extremely difficult
- 8: RF
- 9: DK
Suicidal thoughts and attempts (SUI)
Suicidal thoughts and attempts (SUI) - Question identifier:SUI_R001
The following questions may be sensitive to some people, but we have to ask the same questions of everyone.
Suicidal thoughts and attempts (SUI) - Question identifier:SUI_Q005
Have you ever seriously contemplated suicide?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Suicidal thoughts and attempts (SUI) - Question identifier:SUI_Q010
Has this happened in the past 12 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Suicidal thoughts and attempts (SUI) - Question identifier:SUI_Q015
How old were you the last time this experience happened?
Min = 6; Max = 129
Suicidal thoughts and attempts (SUI) - Question identifier:SUI_Q020
Have you ever made a plan to seriously attempt suicide?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Suicidal thoughts and attempts (SUI) - Question identifier:SUI_Q025
Has this happened in the past 12 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Suicidal thoughts and attempts (SUI) - Question identifier:SUI_Q030
How old were you the last time this experience happened?
Min = 6; Max = 129
Suicidal thoughts and attempts (SUI) - Question identifier:SUI_Q035
Have you ever seriously attempted suicide?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Suicidal thoughts and attempts (SUI) - Question identifier:SUI_Q040
How many times did you seriously attempt suicide in your lifetime?
Min = 1; Max = 901
Suicidal thoughts and attempts (SUI) - Question identifier:SUI_Q045
Did this happen in the past 12 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Suicidal thoughts and attempts (SUI) - Question identifier:SUI_Q050
How old were you [the last time] this experience happened?
Min = 6; Max = 129
Suicidal thoughts and attempts (SUI) - Question identifier:SUI_Q055
Following your most recent experience, did you require medical attention?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Work stress (WST)
Work stress (WST) - Question identifier:WST_R001
The next few questions are about your main job or business in the past 12 months. I'm going to read you a series of statements that might describe your job situation. Please tell me if you strongly agree, agree, neither agree nor disagree, disagree, or strongly disagree.
Work stress (WST) - Question identifier:WST_Q005
Your job required that you learn new things.
- 1: Strongly agree
- 2: Agree
- 3: Neither agree nor disagree
- 4: Disagree
- 5: Strongly disagree
- 8: RF
- 9: DK
Work stress (WST) - Question identifier:WST_Q010
Your job required a high level of skill.
- 1: Strongly agree
- 2: Agree
- 3: Neither agree nor disagree
- 4: Disagree
- 5: Strongly disagree
- 8: RF
- 9: DK
Work stress (WST) - Question identifier:WST_Q015
Your job allowed you freedom to decide how you did your job.
- 1: Strongly agree
- 2: Agree
- 3: Neither agree nor disagree
- 4: Disagree
- 5: Strongly disagree
- 8: RF
- 9: DK
Work stress (WST) - Question identifier:WST_Q020
Your job required that you do things over and over.
- 1: Strongly agree
- 2: Agree
- 3: Neither agree nor disagree
- 4: Disagree
- 5: Strongly disagree
- 8: RF
- 9: DK
Work stress (WST) - Question identifier:WST_Q025
Your job was very hectic.
- 1: Strongly agree
- 2: Agree
- 3: Neither agree nor disagree
- 4: Disagree
- 5: Strongly disagree
- 8: RF
- 9: DK
Work stress (WST) - Question identifier:WST_Q030
You were free from conflicting demands that others made.
- 1: Strongly agree
- 2: Agree
- 3: Neither agree nor disagree
- 4: Disagree
- 5: Strongly disagree
- 8: RF
- 9: DK
Work stress (WST) - Question identifier:WST_Q035
Your job security was good.
- 1: Strongly agree
- 2: Agree
- 3: Neither agree nor disagree
- 4: Disagree
- 5: Strongly disagree
- 8: RF
- 9: DK
Work stress (WST) - Question identifier:WST_Q040
Your job required a lot of physical effort.
- 1: Strongly agree
- 2: Agree
- 3: Neither agree nor disagree
- 4: Disagree
- 5: Strongly disagree
- 8: RF
- 9: DK
Work stress (WST) - Question identifier:WST_Q045
You had a lot to say about what happened in your job.
- 1: Strongly agree
- 2: Agree
- 3: Neither agree nor disagree
- 4: Disagree
- 5: Strongly disagree
- 8: RF
- 9: DK
Work stress (WST) - Question identifier:WST_Q050
You were exposed to hostility or conflict from the people you worked with.
- 1: Strongly agree
- 2: Agree
- 3: Neither agree nor disagree
- 4: Disagree
- 5: Strongly disagree
- 6: Not applicable
- 8: RF
- 9: DK
Work stress (WST) - Question identifier:WST_Q055
Your supervisor was helpful in getting the job done.
- 1: Strongly agree
- 2: Agree
- 3: Neither agree nor disagree
- 4: Disagree
- 5: Strongly disagree
- 6: Not applicable
- 8: RF
- 9: DK
Work stress (WST) - Question identifier:WST_Q060
The people you worked with were helpful in getting the job done.
- 1: Strongly agree
- 2: Agree
- 3: Neither agree nor disagree
- 4: Disagree
- 5: Strongly disagree
- 6: Not applicable
- 8: RF
- 9: DK
Work stress (WST) - Question identifier:WST_Q065
You had the materials and equipment you needed to do your job.
- 1: Strongly agree
- 2: Agree
- 3: Neither agree nor disagree
- 4: Disagree
- 5: Strongly disagree
- 8: RF
- 9: DK
Work stress (WST) - Question identifier:WST_Q070
How satisfied were you with your job?
- 1: Very satisfied
- 2: Somewhat satisfied
- 3: Not too satisfied
- 4: Not at all satisfied
- 8: RF
- 9: DK
Sources of stress (STS)
Sources of stress (STS) - Question identifier:STS_R001
Now a few questions about the stress in your life.
Sources of stress (STS) - Question identifier:STS_Q005
In general, how would you rate your ability to handle unexpected and difficult problems, for example, a family or personal crisis? Would you say your ability is...?
- 1: Excellent
- 2: Good
- 3: Fair
- 4: Poor
- 8: RF
- 9: DK
Sources of stress (STS) - Question identifier:STS_Q010
In general, how would you rate your ability to handle the day-to-day demands in your life, for example, handling work, family and volunteer responsibilities? Would you say your ability is...?
- 1: Excellent
- 2: Good
- 3: Fair
- 4: Poor
- 8: RF
- 9: DK
Sources of stress (STS) - Question identifier:STS_Q015
Thinking about stress in your day-to-day life, what would you say is the most important thing contributing to feelings of stress you may have?
- 01: Work
- 02: Financial concerns
- 03: Family
- 04: School work
- 05: Time pressures / not enough time
- 06: Health
- 07: Other - Specify
- 08: None
- 98: RF
- 99: DK
Social provisions (SPS)
Social provisions (SPS) - Question identifier:SPS_R001
The next questions are about your current relationships with friends, family members, co-workers, community members, and so on. Please indicate to what extent each statement describes your current relationships with other people.
Social provisions (SPS) - Question identifier:SPS_Q005
There are people I can depend on to help me if I really need it.
- 1: Strongly agree
- 2: Agree
- 3: Disagree
- 4: Strongly disagree
- 8: RF
- 9: DK
Social provisions (SPS) - Question identifier:SPS_Q010
There are people who enjoy the same social activities I do.
- 1: Strongly agree
- 2: Agree
- 3: Disagree
- 4: Strongly disagree
- 8: RF
- 9: DK
Social provisions (SPS) - Question identifier:SPS_Q015
I have close relationships that provide me with a sense of emotional security and wellbeing.
- 1: Strongly agree
- 2: Agree
- 3: Disagree
- 4: Strongly disagree
- 8: RF
- 9: DK
Social provisions (SPS) - Question identifier:SPS_Q020
There is someone I could talk to about important decisions in my life.
- 1: Strongly agree
- 2: Agree
- 3: Disagree
- 4: Strongly disagree
- 8: RF
- 9: DK
Social provisions (SPS) - Question identifier:SPS_Q025
I have relationships where my competence and skill are recognized.
- 1: Strongly agree
- 2: Agree
- 3: Disagree
- 4: Strongly disagree
- 8: RF
- 9: DK
Social provisions (SPS) - Question identifier:SPS_Q030
There is a trustworthy person I could turn to for advice if I were having problems.
- 1: Strongly agree
- 2: Agree
- 3: Disagree
- 4: Strongly disagree
- 8: RF
- 9: DK
Social provisions (SPS) - Question identifier:SPS_Q035
I feel part of a group of people who share my attitudes and beliefs.
- 1: Strongly agree
- 2: Agree
- 3: Disagree
- 4: Strongly disagree
- 8: RF
- 9: DK
Social provisions (SPS) - Question identifier:SPS_Q040
I feel a strong emotional bond with at least one other person.
- 1: Strongly agree
- 2: Agree
- 3: Disagree
- 4: Strongly disagree
- 8: RF
- 9: DK
Social provisions (SPS) - Question identifier:SPS_Q045
There are people who admire my talents and abilities.
- 1: Strongly agree
- 2: Agree
- 3: Disagree
- 4: Strongly disagree
- 8: RF
- 9: DK
Social provisions (SPS) - Question identifier:SPS_Q050
There are people I can count on in an emergency.
- 1: Strongly agree
- 2: Agree
- 3: Disagree
- 4: Strongly disagree
- 8: RF
- 9: DK
Primary health care (PHC)
Primary health care (PHC) - Question identifier:PHC_R001
Now I'd like to ask about your primary health care. It is often the first point of entry to the Canadian health system. It incorporates diagnosis, treatment and management of health problems.
Primary health care (PHC) - Question identifier:PHC_Q005
Is there a place that you usually [go] to when you [need] immediate care for a minor health problem?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Primary health care (PHC) - Question identifier:PHC_Q010
What kind of place is it?
- 1: A doctor's office
- 2: A hospital outpatient clinic
- 3: A community health centre [or CLSC]
- 4: A walk-in clinic
- 5: A hospital emergency room
- 6: Some other place
- 8: RF
- 9: DK
Primary health care (PHC) - Question identifier:PHC_Q015
Is this...?
- 1: An office with one doctor working in a solo practice
- 2: An office with several health care professionals working together as a team, that may include a dietician, nurse, social worker or psychologist
- 3: An office with several doctors working independently of each other, who may share one or more nurses
- 4: Other
- 8: RF
- 9: DK
Primary health care (PHC) - Question identifier:PHC_Q020
Do you have a regular health care provider? By this, we mean one health professional that you regularly see or talk to when you need care or advice for your health.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Primary health care (PHC) - Question identifier:PHC_Q025
What are the reasons why you do not have a regular health care provider?
- 1: Do not need one in particular, but you have a usual place of care
- 2: No one available in the area
- 3: No one in the area is taking new patients
- 4: [You] have not tried to find one
- 5: Had one who left or retired
- 6: Other
- 8: RF
- 9: DK
Primary health care (PHC) - Question identifier:PHC_Q030
Is that regular health care provider a...?
- 1: Family doctor or general practitioner
- 2: Medical specialist such as a cardiologist or a pediatrician
- 3: Nurse practitioner
- 4: Other
- 8: RF
- 9: DK
Primary health care (PHC) - Question identifier:PHC_Q035
When you [need] immediate care for a minor health problem, how long do you usually have to wait before you can have an appointment with this [family physician/specialist/nurse practitioner/regular health care provider][, or another care provider from the same office?]
- 1: On the same day
- 2: The next day
- 3: In 2 to 3 days
- 4: In 4 to 6 days
- 5: In 1 to 2 weeks
- 6: Between 2 weeks and one month
- 7: One month or more
- 8: RF
- 9: DK
Primary health care (PHC) - Question identifier:PHC_Q040
Do you usually speak in English, in French or in another language with this [family physician/specialist/nurse practitioner/regular health care provider]?
- 1: English
- 2: French
- 3: English and French
- 4: English and another language
- 5: French and another language
- 6: Another language
- 8: RF
- 9: DK
Primary health care (PHC) - Question identifier:PHC_Q045
Is there one or more nurses working with your [family physician/specialist/nurse practitioner/regular health care provider] who are regularly involved in your health care?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Primary health care (PHC) - Question identifier:PHC_Q050
Other than doctors and nurses, are there other health professionals like nutritionists working in the same office where you get your regular health care?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Primary health care (PHC) - Question identifier:PHC_Q055
Other than from your [family physician/specialist/nurse practitioner/regular health care provider], who do you receive regular health care from?
- 01: Another family doctor or general practitioner
- 02: Specialist doctor
- 03: Nurse / Nurse practitioner
- 04: Chiropractor
- 05: Registered dietician
- 06: Pharmacist
- 07: Physiotherapist
- 08: Psychologist / Mental Health Professional
- 09: Social Worker
- 10: Other
- 11: None
- 98: RF
- 99: DK
Primary health care (PHC) - Question identifier:PHC_Q060
In general, how would you rate the level of coordination between your [family physician/specialist/nurse practitioner/regular health care provider] and other health professionals who provide you with regular care? Would you say the coordination is...?
- 1: Excellent
- 2: Very good
- 3: Good
- 4: Fair
- 5: Poor
- 6: Not applicable
- 8: RF
- 9: DK
Medical Doctor Attachment (MDA)
Medical Doctor Attachment (MDA) - Question identifier:MDA_Q005
How long have you had your family doctor or general practitioner for?
- 1: Less than 6 months
- 2: 6 months to less than 1 year
- 3: 1 year to less than 2 years
- 4: 2 years or more
- 8: RF
- 9: DK
Medical Doctor Attachment (MDA) - Question identifier:MDA_Q010
Are you currently looking for a family doctor or general practitioner?
- 1: Yes
- 2: No
- 3: Not applicable; DT_^NAE
- 8: RF
- 9: DK
Medical Doctor Attachment (MDA) - Question identifier:MDA_Q015
Earlier you said that you have a usual place to go when you need care for a minor health problem. In this place, is there more than one medical doctor who you can see?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Medical Doctor Attachment (MDA) - Question identifier:MDA_Q020
When you ['goes'/'go'] to that usual place, how often are you taken care of by the same medical doctor?
- 1: Always
- 2: Often
- 3: Sometimes
- 4: Rarely
- 5: Never
- 6: Not applicable
- 8: RF
- 9: DK
Contacts with health professionals - part 1 (CHP)
Contacts with health professionals - part 1 (CHP) - Question identifier:CHP_R001
Now I'd like to ask about your contacts with various health professionals and use of various health care services during the past 12 months, that is, from ^DV_DATEONEYEARAGO to yesterday.
Contacts with health professionals - part 1 (CHP) - Question identifier:CHP_R005
Home care services are services provided in your own home because of a health condition or limitation in daily activities; they can include for example, nursing care, meal preparation, someone to help you bathe or do housework. Do not include the help from family, friends or neighbours.
Contacts with health professionals - part 1 (CHP) - Question identifier:CHP_Q005
In the past 12 months, have you received any home care services?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Contacts with health professionals - part 1 (CHP) - Question identifier:CHP_Q010
In the past 12 months, how many times have you personally used a hospital emergency room?
Min = 0; Max = 900
Contacts with health professionals - part 1 (CHP) - Question identifier:CHP_Q015
The last time you went, what were the reasons you went to the emergency room instead of any other health care service (like a doctor's office)?
- 01: It was clearly an emergency
- 02: [You] didn't know if your health condition was an emergency
- 03: It was not an emergency but you felt you would see a health professional or get the test you needed done faster
- 04: [You] were told to go to the emergency department for follow-up or appointment
- 05: [Your] primary health care provider was not available at the time you needed it (after hours of clinic, doctor away)
- 06: [You] do not have a primary health care provider
- 07: [You] use the emergency department for all your health concerns
- 08: Other
- 98: RF
- 99: DK
Contacts with health professionals - part 1 (CHP) - Question identifier:CHP_Q020
The last time you went to the emergency room, was it for a condition that you thought could have been treated by your primary care provider if he/she had been available?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Contacts with health professionals - part 1 (CHP) - Question identifier:CHP_Q025
[In/Excluding the time you spent in an emergency department, in] the past 12 months, have you been a patient overnight in a hospital?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Contacts with health professionals - part 1 (CHP) - Question identifier:CHP_Q030
For how many nights in the past 12 months?
Min = 1; Max = 366
Contacts with health professionals - part 1 (CHP) - Question identifier:CHP_Q035
The last time you were an overnight patient in a hospital, what were the reasons for this hospitalisation?
- 1: Post-surgery
- 2: Was too sick to go home/ admitted from ER
- 3: Waiting for care in nursing home
- 4: Waiting for home care
- 5: Postpartum care
- 6: Other
- 8: RF
- 9: DK
Contacts with health professionals - part 1 (CHP) - Question identifier:CHP_Q040
[Not counting when you were an overnight patient, in the past 12 months], have you seen or talked to any of the following health professionals about your physical, emotional or mental health:
a family doctor[, pediatrician] or general practitioner?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Contacts with health professionals - part 1 (CHP) - Question identifier:CHP_Q045
How many times (in the past 12 months)?
Min = 1; Max = 366
Contacts with health professionals - part 1 (CHP) - Question identifier:CHP_Q050
([Not counting when you were an overnight patient, in the past 12 months], have you seen or talked to:)
an eye specialist, such as an ophthalmologist or optometrist?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Contacts with health professionals - part 1 (CHP) - Question identifier:CHP_Q055
How many times (in the past 12 months)?
Min = 1; Max = 75
Contacts with health professionals - part 1 (CHP) - Question identifier:CHP_Q060
[Not counting when you were an overnight patient, in the past 12 months], have you seen or talked to:
any other medical doctor or specialist such as a surgeon, allergist, orthopaedist, [urologist/gynaecologist] or psychiatrist (about your physical, emotional or mental health)?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Contacts with health professionals - part 1 (CHP) - Question identifier:CHP_Q065
How many times (in the past 12 months)?
Min = 1; Max = 300
Contacts with health professionals - part 1 (CHP) - Question identifier:CHP_Q070
[Not counting when you were an overnight patient, in the past 12 months], have you seen or talked to:
a nurse for care or advice about your physical, emotional or mental health?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Contacts with health professionals - part 1 (CHP) - Question identifier:CHP_Q075
How many times (in the past 12 months)?
Min = 1; Max = 366
Contacts with health professionals - part 1 (CHP) - Question identifier:CHP_Q080
([Not counting when you were an overnight patient, in the past 12 months], have you seen or talked to:)
a dental professional, such as a dentist, a dental hygienist or a denturologist?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Contacts with health professionals - part 1 (CHP) - Question identifier:CHP_Q085
How many times (in the past 12 months)?
Min = 1; Max = 99
Patient satisfaction - community-based care (PSC)
Patient satisfaction - community-based care (PSC) - Question identifier:PSC_R001
The next questions are about community-based health care which include other health care services received outside of a hospital or doctor's office.
Examples are: home nursing care, home-based counselling or therapy, personal care and community health clinics.
Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q005
In the past 12 months, have you received any community-based care?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q010
Overall, how would you rate the quality of the community-based care you received? Would you say it was...?
- 1: Excellent
- 2: Good
- 3: Fair
- 4: Poor
- 8: RF
- 9: DK
Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q015
Using a scale of 0 to 5, where 0 means "Very dissatisfied" and 5 means "Very satisfied", overall, how satisfied were you with the way community-based care was provided?
- 0: Very dissatisfied
- 1: |
- 2: |
- 3: |
- 4: V
- 5: Very satisfied
- 8: RF
- 9: DK
Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q020
In the past 12 months, have you received any home nursing care?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q025
Overall, how would you rate the quality of the home nursing care you received? Would you say it was...?
- 1: Excellent
- 2: Good
- 3: Fair
- 4: Poor
- 8: RF
- 9: DK
Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q030
Using a scale of 0 to 5, where 0 means "Very dissatisfied" and 5 means "Very satisfied", overall, how satisfied were you with the way the home nursing care was provided?
- 0: Very dissatisfied
- 1: |
- 2: |
- 3: |
- 4: V
- 5: Very satisfied
- 8: RF
- 9: DK
Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q035
In the past 12 months, have you received any home-based counselling or therapy?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q040
Overall, how would you rate the quality of the home-based counselling or therapy you received? Would you say it was...?
- 1: Excellent
- 2: Good
- 3: Fair
- 4: Poor
- 8: RF
- 9: DK
Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q045
Using a scale of 0 to 5, where 0 means "Very dissatisfied" and 5 means "Very satisfied", overall, how satisfied were you with the way the home-based counselling or therapy was provided?
- 0: Very dissatisfied
- 1: |
- 2: |
- 3: |
- 4: V
- 5: Very satisfied
- 8: RF
- 9: DK
Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q050
In the past 12 months, have you received any personal care services?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q055
Overall, how would you rate the quality of the personal care service you received? Would you say it was...?
- 1: Excellent
- 2: Good
- 3: Fair
- 4: Poor
- 8: RF
- 9: DK
Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q060
Using a scale of 0 to 5, where 0 means "Very dissatisfied" and 5 means "Very satisfied", overall, how satisfied were you with the way the personal care service was provided?
- 0: Very dissatisfied
- 1: |
- 2: |
- 3: |
- 4: V
- 5: Very satisfied
- 8: RF
- 9: DK
Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q065
In the past 12 months, have you received any services from a community walk-in clinic?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q070
Overall, how would you rate the quality of the service you received at the community walk-in clinic? Would you say it was...?
- 1: Excellent
- 2: Good
- 3: Fair
- 4: Poor
- 8: RF
- 9: DK
Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q075
Using a scale of 0 to 5, where 0 means "Very dissatisfied" and 5 means "Very satisfied", overall, how satisfied were you with the way the community walk-in clinic service was provided?
- 0: Very dissatisfied
- 1: |
- 2: |
- 3: |
- 4: V
- 5: Very satisfied
- 8: RF
- 9: DK
Patient experiences (PEX)
Patient experiences (PEX) - Question identifier:PEX_R001
The next questions are about your last consultation with a health professional.
Patient experiences (PEX) - Question identifier:PEX_Q005
When was the last time that you had a consultation with any health professional about your own health? Exclude care you got when you stayed overnight in a hospital, dental care visits, accident or emergency care, or care received in your home.
- 1: In the last 30 days
- 2: Between 1 and 3 months ago
- 3: More than 3 but less than 6 months ago
- 4: Between 6 and 12 months ago
- 5: Between 1 and 2 years ago
- 6: More than 2 years ago
- 8: RF
- 9: DK
Patient experiences (PEX) - Question identifier:PEX_Q010
Thinking about this last consultation, who did you receive care from?
- 1: A general practitioner or family doctor
- 2: A medical specialist
- 3: A nurse
- 4: Another health professional, such as a physiotherapist, psychologist or a speech therapist
- 8: RF
- 9: DK
Patient experiences (PEX) - Question identifier:PEX_Q015
Where did this last consultation take place?
- 01: At a doctor's office working in solo practice
- 02: At a doctor's office working in a team practice
- 03: At an office with many doctors working independently
- 04: At a hospital outpatient clinic
- 05: At a community health centre [or CLSC]
- 06: At a walk-in clinic
- 07: At a hospital emergency room
- 08: Over the telephone (for example [Info-Santé/Telehealth Ontario/HealthLinks/Health-Line/Telecare/on a health info line])
- 09: Other
- 98: RF
- 99: DK
Patient experiences (PEX) - Question identifier:PEX_Q020
Is this the place that you usually go to for most of your immediate care for a minor health problem?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Patient experiences (PEX) - Question identifier:PEX_Q025
Did you need to make an appointment to obtain this last consultation?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Patient experiences (PEX) - Question identifier:PEX_Q030
How quickly did you get this appointment?
- 1: On the same day
- 2: The next day
- 3: In 2 to 3 days
- 4: In 4 to 6 days
- 5: In 1 to 2 weeks
- 6: Between 2 weeks and one month
- 7: One month or more
- 8: RF
- 9: DK
Patient experiences (PEX) - Question identifier:PEX_Q035
Was the time you waited for the appointment a problem for you?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Patient experiences (PEX) - Question identifier:PEX_Q040
Were you seen by the [general practitioner/medical specialist/nurse/health professional] [(or a nurse) at] the scheduled time of your appointment?
- 1: Appointment was on time or sooner than scheduled
- 2: Appointment was late
- 8: RF
- 9: DK
Patient experiences (PEX) - Question identifier:PEX_Q045
How long did you wait between the time of your appointment and the time you were seen by the [general practitioner/medical specialist/nurse/health professional]?
- 1: Less than 15 minutes
- 2: 15 to less than 30 minutes
- 3: 30 minutes to less than one hour
- 4: 1 to less than 2 hours
- 5: 2 hours or more
- 8: RF
- 9: DK
Patient experiences (PEX) - Question identifier:PEX_Q050
Was the time you waited a problem for you?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Patient experiences (PEX) - Question identifier:PEX_Q055
Did the [general practitioner/medical specialist/nurse/health professional] spend enough time with you during this last consultation?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Patient experiences (PEX) - Question identifier:PEX_Q060
Was your blood pressure measured (during this last consultation)?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Patient experiences (PEX) - Question identifier:PEX_Q065
Did this [general practitioner/medical specialist/nurse/health professional] explain things in a way that was easy to understand?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Patient experiences (PEX) - Question identifier:PEX_Q070
Did this [general practitioner/medical specialist/nurse/health professional] give you an opportunity to ask questions or raise concerns about your care or recommended treatment?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Patient experiences (PEX) - Question identifier:PEX_Q075
Did this [general practitioner/medical specialist/nurse/health professional] involve you as much as you could have been in decisions about your care or treatment?
- 1: Yes
- 2: No
- 3: Did not want to be involved
- 8: RF
- 9: DK
Patient experiences (PEX) - Question identifier:PEX_Q080
Did this [general practitioner/medical specialist/nurse/health professional] tell you how much the recommended treatment would cost, or whether any lower cost alternatives were available?
- 1: Yes
- 2: No
- 3: Not applicable, no recommended treatment or no cost implications
- 8: RF
- 9: DK
Patient experiences (PEX) - Question identifier:PEX_Q085
Overall, how would you rate the quality of this consultation?
- 1: Excellent
- 2: Very good
- 3: Good
- 4: Fair
- 5: Poor
- 8: RF
- 9: DK
Patient experiences (PEX) - Question identifier:PEX_R090
Now, a question about prescriptions for medicine.
Patient experiences (PEX) - Question identifier:PEX_Q090
During the last 12 months, was there a time when you did not fill or collect a prescription for medicine, or you skipped doses of your medicine because of the cost?
- 1: Yes
- 2: No
- 3: Not applicable, I had no medication prescription to fill in the last 12 months
- 8: RF
- 9: DK
Access to health care services (ACC)
Access to health care services (ACC) - Question identifier:ACC_R001
The next questions are about the use of various health care services.
I will start by asking about your experiences getting health care from a medical specialist such as a cardiologist, endocrinologist, allergist, [urologist/gynaecologist] or psychiatrist (excluding an optometrist).
Access to health care services (ACC) - Question identifier:ACC_Q005
In the past 12 months, did you require a visit to a medical specialist for a diagnosis or a consultation?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Access to health care services (ACC) - Question identifier:ACC_Q010
In the past 12 months, did you ever experience any difficulties getting the specialist care you needed for a diagnosis or consultation?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Access to health care services (ACC) - Question identifier:ACC_Q015
What types of difficulties did you experience?
- 01: Difficulty getting a referral
- 02: Difficulty getting an appointment
- 03: Waited too long between booking appointment and visit
- 04: Waited too long to see the specialist (i.e. in-office waiting)
- 05: Service not available at time required
- 06: Service not available in the area
- 07: Transportation problems
- 08: Language problem
- 09: Cost
- 10: General deterioration of health
- 11: Appointment cancelled or deferred by specialist
- 12: Unable to leave the house because of a health problem
- 13: Other
- 98: RF
- 99: DK
Access to health care services (ACC) - Question identifier:ACC_R020
The following questions are about any surgery, not provided in an emergency, that you may have required, such as cardiac surgery, joint surgery - knee or hip[, caesarean sections] and cataract surgery, excluding laser eye surgery.
Access to health care services (ACC) - Question identifier:ACC_Q020
In the past 12 months, did you require any non-emergency surgery?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Access to health care services (ACC) - Question identifier:ACC_Q025
In the past 12 months, did you ever experience any difficulties getting the surgery you needed?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Access to health care services (ACC) - Question identifier:ACC_Q030
What types of difficulties did you experience?
- 01: Difficulty getting an appointment
- 02: Difficulty getting a diagnosis including obtaining a diagnostic test
- 03: Waited too long for a hospital bed to become available
- 04: Waited too long for surgery
- 05: Service not available at time required
- 06: Service not available in the area
- 07: Transportation problems
- 08: Language problem
- 09: Cost
- 10: General deterioration of health
- 11: Appointment cancelled or deferred by surgeon or hospital
- 12: Unable to leave the house because of a health problem
- 13: Other
- 98: RF
- 99: DK
Access to health care services (ACC) - Question identifier:ACC_R035
Now, some questions about MRIs, CAT Scans and angiographies provided in a non-emergency situation.
Access to health care services (ACC) - Question identifier:ACC_Q035
In the past 12 months, did you require one of these tests?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Access to health care services (ACC) - Question identifier:ACC_Q040
In the past 12 months, did you ever experience any difficulties getting the tests you needed?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Access to health care services (ACC) - Question identifier:ACC_Q045
What types of difficulties did you experience?
- 01: Difficulty getting a referral
- 02: Difficulty getting an appointment
- 03: Waited too long to get an appointment
- 04: Waited too long to get test (i.e. in-office waiting)
- 05: Service not available at time required
- 06: Service not available in the area
- 07: Transportation problems
- 08: Language problem
- 09: Cost
- 10: General deterioration of health
- 11: Did not know where to go (i.e. information problems)
- 12: Unable to leave the house because of a health problem
- 13: Other
- 98: RF
- 99: DK
Access to health care services (ACC) - Question identifier:ACC_R050A
Now, I'd like you to think about yourself and family members living in your dwelling.
The next questions are about your experiences getting health information or advice when you needed it for yourself or a family member living in your dwelling.
Access to health care services (ACC) - Question identifier:ACC_R050B
The next questions are about your experiences getting health information or advice when you needed it.
Access to health care services (ACC) - Question identifier:ACC_Q050
In the past 12 months, have you required health information or advice [for yourself or a family member]?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Access to health care services (ACC) - Question identifier:ACC_Q055
Whom did you contact when you needed health information or advice [for yourself or a family member]?
- 01: A doctor's office
- 02: A community health centre [or CLSC]
- 03: A walk-in clinic
- 04: A Telephone health line (for example, HealthLinks, Telehealth Ontario, Health-Line, TeleCare, Info-Santé)
- 05: Internet (for example, AboutKidsHealth)
- 06: An emergency department or emergency room
- 07: A hospital outpatient clinic
- 08: Other - Specify
- 98: RF
- 99: DK
Access to health care services (ACC) - Question identifier:ACC_Q060
In the past 12 months, did you ever experience any difficulties getting the health information or advice [for yourself or a family member]?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Access to health care services (ACC) - Question identifier:ACC_Q065
Did you experience difficulties during "regular" office hours (that is, 9:00 am to 5:00 pm, Monday to Friday)?
- 1: Yes
- 2: No
- 3: Not required at this time
- 8: RF
- 9: DK
Access to health care services (ACC) - Question identifier:ACC_Q070
What types of difficulties did you experience?
- 01: Difficulty contacting a physician or nurse
- 02: Did not have a phone number
- 03: Could not get through (i.e. no answer)
- 04: Waited too long to speak to someone
- 05: Did not get adequate info or advice
- 06: Language problem
- 07: Did not know where to go / call / uninformed
- 08: Unable to leave the house because of a health problem
- 09: Other
- 98: RF
- 99: DK
Access to health care services (ACC) - Question identifier:ACC_Q075
Did you experience difficulties getting health information or advice during evenings and weekends (that is, 5:00 pm to 9:00 pm Monday to Friday, or 9:00 am to 5:00 pm, Saturdays and Sundays)?
- 1: Yes
- 2: No
- 3: Not required at this time
- 8: RF
- 9: DK
Access to health care services (ACC) - Question identifier:ACC_Q080
What types of difficulties did you experience?
- 01: Difficulty contacting a physician or nurse
- 02: Did not have a phone number
- 03: Could not get through (i.e. no answer)
- 04: Waited too long to speak to someone
- 05: Did not get adequate info or advice
- 06: Language problem
- 07: Did not know where to go / call / uninformed
- 08: Unable to leave the house because of a health problem
- 09: Other
- 98: RF
- 99: DK
Access to health care services (ACC) - Question identifier:ACC_Q085
Did you experience difficulties getting health information or advice during the middle of the night?
- 1: Yes
- 2: No
- 3: Not required at this time
- 8: RF
- 9: DK
Access to health care services (ACC) - Question identifier:ACC_Q090
What types of difficulties did you experience?
- 01: Difficulty contacting a physician or nurse
- 02: Did not have a phone number
- 03: Could not get through (i.e. no answer)
- 04: Waited too long to speak to someone
- 05: Did not get adequate info or advice
- 06: Language problem
- 07: Did not know where to go / call / uninformed
- 08: Unable to leave the house because of a health problem
- 09: Other
- 98: RF
- 99: DK
Access to health care services (ACC) - Question identifier:ACC_R095A
Now, some questions about your experiences when you needed health care services for routine or on-going care such as a medical or dental exam or follow-up for yourself or a family member living in your dwelling.
Access to health care services (ACC) - Question identifier:ACC_R095B
Now, some questions about your experiences when you needed health care services for routine or on-going care such as a medical or dental exam or follow-up.
Access to health care services (ACC) - Question identifier:ACC_Q095
Do you have a regular health care provider?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Access to health care services (ACC) - Question identifier:ACC_Q100
In the past 12 months, did you require any routine or on-going care [for yourself or a family member]?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Access to health care services (ACC) - Question identifier:ACC_Q105
In the past 12 months, did you ever experience any difficulties getting the routine or on-going care [you or a family member] needed?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Access to health care services (ACC) - Question identifier:ACC_Q110
Did you experience difficulties getting such care during "regular" office hours (that is, 9:00 am to 5:00 pm, Monday to Friday)?
- 1: Yes
- 2: No
- 3: Not required at this time
- 8: RF
- 9: DK
Access to health care services (ACC) - Question identifier:ACC_Q115
What types of difficulties did you experience?
- 01: Difficulty contacting a health care provider
- 02: Difficulty getting an appointment
- 03: Do not have a regular health care provider
- 04: Waited too long to get an appointment
- 05: Waited too long to see the health care provider (i.e. in-office waiting)
- 06: Service not available at time required
- 07: Service not available in the area
- 08: Transportation problems
- 09: Language problem
- 10: Cost
- 11: Did not know where to go (i.e. information problems)
- 12: Unable to leave the house because of a health problem
- 13: Other
- 98: RF
- 99: DK
Access to health care services (ACC) - Question identifier:ACC_Q120
Did you experience difficulties getting such care during evenings and weekends (that is, 5:00 pm to 9:00 pm, Monday to Friday, or 9:00 am to 5:00 pm, Saturdays and Sundays)?
- 1: Yes
- 2: No
- 3: Not required at this time
- 8: RF
- 9: DK
Access to health care services (ACC) - Question identifier:ACC_Q125
What types of difficulties did you experience?
- 01: Difficulty contacting a health care provider
- 02: Difficulty getting an appointment
- 03: Do not have a regular health care provider
- 04: Waited too long to get an appointment
- 05: Waited too long to see the health care provider (i.e. in-office waiting)
- 06: Service not available at time required
- 07: Service not available in the area
- 08: Transportation problems
- 09: Language problem
- 10: Cost
- 11: Did not know where to go (i.e. information problems)
- 12: Unable to leave the house because of a health problem
- 13: Other
- 98: RF
- 99: DK
Access to health care services (ACC) - Question identifier:ACC_R130
The next questions are about situations when [you or a family member] have needed immediate care for a minor health problem such as fever, headache, a sprained ankle, vomiting or an unexplained rash.
Access to health care services (ACC) - Question identifier:ACC_Q130
In the past 12 months, did [you or a family member] require immediate health care services for a minor health problem?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Access to health care services (ACC) - Question identifier:ACC_Q135
In the past 12 months, did you ever experience any difficulties getting the immediate care needed for a minor health problem [for yourself or a family member]?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Access to health care services (ACC) - Question identifier:ACC_Q140
Did you experience difficulties getting such care during "regular" office hours (that is, 9:00 am to 5:00 pm, Monday to Friday)?
- 1: Yes
- 2: No
- 3: Not required at this time
- 8: RF
- 9: DK
Access to health care services (ACC) - Question identifier:ACC_Q145
What types of difficulties did you experience?
- 01: Difficulty contacting a health care provider
- 02: Difficulty getting an appointment
- 03: Do not have a regular health care provider
- 04: Waited too long to get an appointment
- 05: Waited too long to see the health care provider (i.e. in-office waiting)
- 06: Service not available at time required
- 07: Service not available in the area
- 08: Transportation problems
- 09: Language problem
- 10: Cost
- 11: Did not know where to go (i.e. information problems)
- 12: Unable to leave the house because of a health problem
- 13: Other
- 98: RF
- 99: DK
Access to health care services (ACC) - Question identifier:ACC_Q150
Did you experience difficulties getting such care during evenings and weekends (that is, 5:00 pm to 9:00 pm, Monday to Friday, or 9:00 am to 5:00 pm, Saturdays and Sundays)?
- 1: Yes
- 2: No
- 3: Not required at this time
- 8: RF
- 9: DK
Access to health care services (ACC) - Question identifier:ACC_Q155
What types of difficulties did you experience?
- 01: Difficulty contacting a health care provider
- 02: Difficulty getting an appointment
- 03: Do not have a regular health care provider
- 04: Waited too long to get an appointment
- 05: Waited too long to see the health care provider (i.e. in-office waiting)
- 06: Service not available at time required
- 07: Service not available in the area
- 08: Transportation problems
- 09: Language problem
- 10: Cost
- 11: Did not know where to go (i.e. information problems)
- 12: Unable to leave the house because of a health problem
- 13: Other
- 98: RF
- 99: DK
Access to health care services (ACC) - Question identifier:ACC_Q160
Did you experience difficulties getting such care during the middle of the night?
- 1: Yes
- 2: No
- 3: Not required at this time
- 8: RF
- 9: DK
Access to health care services (ACC) - Question identifier:ACC_Q165
What types of difficulties did you experience?
- 01: Difficulty contacting a health care provider
- 02: Difficulty getting an appointment
- 03: Do not have a regular health care provider
- 04: Waited too long to get an appointment
- 05: Waited too long to see the health care provider (i.e. in-office waiting)
- 06: Service not available at time required
- 07: Service not available in the area
- 08: Transportation problems
- 09: Language problem
- 10: Cost
- 11: Did not know where to go (i.e. information problems)
- 12: Unable to leave the house because of a health problem
- 13: Other
- 98: RF
- 99: DK
Waiting times (WTM)
Waiting times (WTM) - Question identifier:WTM_R001
Now some additional questions about your experiences waiting for health care services.
Waiting times (WTM) - Question identifier:WTM_Q005
You mentioned that you required a visit to a medical specialist such as a cardiologist, endocrinologist, allergist[, gynaecologist] or psychiatrist.
In the past 12 months, did you require a visit to a medical specialist for a diagnosis or a consultation for a new illness or condition?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Waiting times (WTM) - Question identifier:WTM_Q010
For what type of condition?
If you have had more than one such visit, please answer for the most recent visit.
- 01: Heart condition or stroke
- 02: Cancer
- 03: Asthma or other breathing conditions
- 04: Arthritis
- 05: Cataract or other eye conditions
- 06: Mental health disorder
- 07: Diabetes
- 08: Skin conditions
- 09: Gynaecological problems
- 10: Other - Specify
- 98: RF
- 99: DK
Waiting times (WTM) - Question identifier:WTM_Q015
Were you referred by...?
- 1: A family doctor
- 2: Another specialist
- 3: Another health care provider
- 4: Did not require a referral
- 8: RF
- 9: DK
Waiting times (WTM) - Question identifier:WTM_Q020
Have you already visited the medical specialist?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Waiting times (WTM) - Question identifier:WTM_Q025
Thinking about this visit, did you experience any difficulties seeing the specialist?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Waiting times (WTM) - Question identifier:WTM_Q030
What type of difficulties did you experience?
- 01: Difficulty getting a referral
- 02: Difficulty getting an appointment
- 03: Waited too long between booking appointment and visit
- 04: Waited too long to see the doctor (i.e. in-office waiting)
- 05: Service not available at time required
- 06: Service not available in the area
- 07: Transportation problems
- 08: Language problem
- 09: Cost
- 10: General deterioration of health
- 11: Appointment cancelled or deferred by specialist
- 12: Unable to leave the house because of a health problem
- 13: Other
- 98: RF
- 99: DK
Waiting times (WTM) - Question identifier:WTM_Q035
How long did you have to wait between when [you and your health care provider decided that you should see a specialist/the appointment was initially scheduled] and when you actually visited the specialist?
Min = 1; Max = 365
Waiting times (WTM) - Question identifier:WTM_N035A
Enter unit of time. Please ask respondent to convert to months if response was provided in years (ex. 1 year and half = 18 months, 2 years = 24 months, etc).
- 1: Days
- 2: Weeks
- 3: Months
Waiting times (WTM) - Question identifier:WTM_Q040
How long have you been waiting since [you and your health care provider decided that you should see a specialist/the appointment was initially scheduled]?
Min = 1; Max = 365
Waiting times (WTM) - Question identifier:WTM_N040A
Enter unit of time.
- 1: Days
- 2: Weeks
- 3: Months
Waiting times (WTM) - Question identifier:WTM_Q045
In your view, [was the waiting time/has the waiting time been]...?
- 1: Acceptable
- 2: Not acceptable
- 3: No view
- 8: RF
- 9: DK
Waiting times (WTM) - Question identifier:WTM_Q050
In this particular case, what do you think is an acceptable waiting time?
Min = 1; Max = 365
Waiting times (WTM) - Question identifier:WTM_N050A
Enter unit of time.
- 1: Days
- 2: Weeks
- 3: Months
Waiting times (WTM) - Question identifier:WTM_Q055
Was your visit cancelled or postponed at any time?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Waiting times (WTM) - Question identifier:WTM_Q060
Was it cancelled or postponed by...?
- 1: Yourself
- 2: The specialist
- 3: Other
- 8: RF
- 9: DK
Waiting times (WTM) - Question identifier:WTM_Q065
Do you think that your health, or other aspects of your life, have been affected in any way because you had to wait for this visit?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Waiting times (WTM) - Question identifier:WTM_Q070
How was your life affected as a result of waiting for this visit?
- 01: Worry, anxiety, stress
- 02: Worry or stress for family or friends
- 03: Pain
- 04: Problems with activities of daily living (e.g., dressing, driving)
- 05: Loss of work
- 06: Loss of income
- 07: Increased dependence on relatives or friends
- 08: Increased use of over-the-counter drugs
- 09: Overall health deteriorated, condition got worse
- 10: Health problem improved
- 11: Personal relationships suffered
- 12: Other
- 98: RF
- 99: DK
Waiting times (WTM) - Question identifier:WTM_Q075
You mentioned that in the past 12 months you required non-emergency surgery.
What type of surgery did you require? If you have had more than one in the past 12 months, please answer for the most recent surgery.
- 1: Cardiac surgery
- 2: Cancer related surgery
- 3: Hip or knee replacement surgery
- 4: Cataract or other eye surgery
- 5: Hysterectomy (Removal of uterus)
- 6: Removal of gall bladder
- 7: Other - Specify
- 8: RF
- 9: DK
Waiting times (WTM) - Question identifier:WTM_Q080
Did you already have this surgery?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Waiting times (WTM) - Question identifier:WTM_Q085
Did the surgery require an overnight hospital stay?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Waiting times (WTM) - Question identifier:WTM_Q090
Did you experience any difficulties getting this surgery?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Waiting times (WTM) - Question identifier:WTM_Q095
What types of difficulties did you experience?
- 01: Difficulty getting an appointment
- 02: Difficulty getting a diagnosis including obtaining a diagnostic test
- 03: Waited too long for a hospital bed to become available
- 04: Waited too long for surgery
- 05: Service not available at time required
- 06: Service not available in the area
- 07: Transportation problems
- 08: Language problem
- 09: Cost
- 10: General deterioration of health
- 11: Appointment cancelled or deferred by surgeon or hospital
- 12: Unable to leave the house because of a health problem
- 13: Other
- 98: RF
- 99: DK
Waiting times (WTM) - Question identifier:WTM_Q100
How long did you have to wait between when you and the surgeon decided to go ahead with surgery and the day of surgery?
Min = 1; Max = 365
Waiting times (WTM) - Question identifier:WTM_N100A
Enter unit of time.
- 1: Days
- 2: Weeks
- 3: Months
Waiting times (WTM) - Question identifier:WTM_Q105
Will the surgery require an overnight hospital stay?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Waiting times (WTM) - Question identifier:WTM_Q110
How long have you been waiting since you and the surgeon decided to go ahead with the surgery?
Min = 1; Max = 365
Waiting times (WTM) - Question identifier:WTM_N110A
Enter unit of time.
- 1: Days
- 2: Weeks
- 3: Months
Waiting times (WTM) - Question identifier:WTM_Q115
In your view, [was the waiting time/has the waiting time been]...?
- 1: Acceptable
- 2: Not acceptable
- 3: No view
- 8: RF
- 9: DK
Waiting times (WTM) - Question identifier:WTM_Q120
In this particular case, what do you think is an acceptable waiting time?
Min = 1; Max = 365
Waiting times (WTM) - Question identifier:WTM_N120A
Enter unit of time.
- 1: Days
- 2: Weeks
- 3: Months
Waiting times (WTM) - Question identifier:WTM_Q125
Was your surgery cancelled or postponed at any time?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Waiting times (WTM) - Question identifier:WTM_Q130
Was it cancelled or postponed by...?
- 1: Yourself
- 2: The surgeon
- 3: The hospital
- 4: Other
- 8: RF
- 9: DK
Waiting times (WTM) - Question identifier:WTM_Q135
Do you think that your health, or other aspects of your life, have been affected in any way due to waiting for this surgery?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Waiting times (WTM) - Question identifier:WTM_Q140
How was your life affected as a result of waiting for surgery?
- 01: Worry, anxiety, stress
- 02: Worry or stress for family or friends
- 03: Pain
- 04: Problems with activities of daily living (e.g., dressing, driving)
- 05: Loss of work
- 06: Loss of income
- 07: Increased dependence on relatives or friends
- 08: Increased use of over-the-counter drugs
- 09: Overall health deteriorated, condition got worse
- 10: Health problem improved
- 11: Personal relationships suffered
- 12: Other
- 98: RF
- 99: DK
Waiting times (WTM) - Question identifier:WTM_Q145
Now for MRIs, CAT Scans and angiographies provided in a non-emergency situation.
You mentioned that in the past 12 months you required one of these tests.
What type of test did you require?
If there was more than one in the past 12 months, please answer for the most recent test.
- 1: MRI (Magnetic Resonance Imaging)
- 2: CAT Scan (Computed Axial Tomography)
- 3: Angiography (Cardiac Test)
- 4: None
- 8: RF
- 9: DK
Waiting times (WTM) - Question identifier:WTM_Q150
For what type of condition?
- 1: Heart disease or stroke
- 2: Cancer
- 3: Joints or fractures
- 4: Neurological or brain disorders (e.g., for MS, migraine or headaches)
- 5: Other - Specify
- 8: RF
- 9: DK
Waiting times (WTM) - Question identifier:WTM_Q155
Did you already have this test?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Waiting times (WTM) - Question identifier:WTM_Q160
Where was the test done?
- 1: Hospital
- 2: Public clinic
- 3: Private clinic
- 4: Other
- 8: RF
- 9: DK
Waiting times (WTM) - Question identifier:WTM_Q165
Was the clinic located...?
- 1: In your province or territory
- 2: In another province or territory
- 3: Other
- 8: RF
- 9: DK
Waiting times (WTM) - Question identifier:WTM_Q170
Were you a patient in a hospital at the time of the test?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Waiting times (WTM) - Question identifier:WTM_Q175
Did you experience any difficulties getting this test?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Waiting times (WTM) - Question identifier:WTM_Q180
What types of difficulties did you experience?
- 01: Difficulty getting a referral
- 02: Difficulty getting an appointment
- 03: Waited too long to get an appointment
- 04: Waited too long to get test (i.e. in-office waiting)
- 05: Service not available at time required
- 06: Service not available in the area
- 07: Transportation problems
- 08: Language problem
- 09: Cost
- 10: General deterioration of health
- 11: Did not know where to go (i.e. information problems)
- 12: Unable to leave the house because of a health problem
- 13: Other
- 98: RF
- 99: DK
Waiting times (WTM) - Question identifier:WTM_Q185
How long did you have to wait between when you and your doctor decided to go ahead with the test and the day of the test?
Min = 1; Max = 365
Waiting times (WTM) - Question identifier:WTM_N185A
Enter unit of time.
- 1: Days
- 2: Weeks
- 3: Months
Waiting times (WTM) - Question identifier:WTM_Q190
How long have you been waiting for the test since you and your doctor decided to go ahead with the test?
Min = 1; Max = 365
Waiting times (WTM) - Question identifier:WTM_N190A
Enter unit of time.
- 1: Days
- 2: Weeks
- 3: Months
Waiting times (WTM) - Question identifier:WTM_Q195
In your view, [was the waiting time/has the waiting time been]...?
- 1: Acceptable
- 2: Not acceptable
- 3: No view
- 8: RF
- 9: DK
Waiting times (WTM) - Question identifier:WTM_Q200
In this particular case, what do you think is an acceptable waiting time?
Min = 1; Max = 365
Waiting times (WTM) - Question identifier:WTM_N200A
Enter unit of time.
- 1: Days
- 2: Weeks
- 3: Months
Waiting times (WTM) - Question identifier:WTM_Q205
Was your test cancelled or postponed at any time?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Waiting times (WTM) - Question identifier:WTM_Q210
Was it cancelled or postponed by...?
- 1: Yourself
- 2: The specialist
- 3: The hospital
- 4: The clinic
- 5: Other
- 8: RF
- 9: DK
Waiting times (WTM) - Question identifier:WTM_Q215
Do you think that your health, or other aspects of your life, have been affected in any way due to waiting for this test?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Waiting times (WTM) - Question identifier:WTM_Q220
How was your life affected as a result of waiting for this test?
- 01: Worry, anxiety, stress
- 02: Worry or stress for family or friends
- 03: Pain
- 04: Problems with activities of daily living (e.g., dressing, driving)
- 05: Loss of work
- 06: Loss of income
- 07: Increased dependence on relatives or friends
- 08: Increased use of over-the-counter drugs
- 09: Overall health deteriorated, condition got worse
- 10: Health problem improved
- 11: Personal relationships suffered
- 12: Other
- 98: RF
- 99: DK
Home care services (HMC)
Home care services (HMC) - Question identifier:HMC_R005
Now some questions on home care services that [you or anyone in your household] may have received because of a health condition or a limitation in daily activities. These include services provided in your own home such as nursing care, meal preparation, someone to help with bathing or housework, etc. Do not include the help from family, friends or neighbours.
Home care services (HMC) - Question identifier:HMC_Q005
In the past 12 months, what type of home care services have [you or anyone in your household] received?
- 1: Nursing care (e.g., dressing changes, preparing
medications, V.O.N. visits) - 2: Other health care services (e.g., physiotherapy,
occupational or speech therapy, nutrition counselling) - 3: Medical equipment or supplies (e.g., wheelchair, pads for incontinence, help with using a ventilator or oxygen equipment)
- 4: Personal or home support (such as bathing, housekeeping, meal preparation)
- 5: Other services (such as transportation, meals-on-wheels)
- 6: No one in the household received any home care services
- 8: RF
- 9: DK
Home care services (HMC) - Question identifier:HMC_Q010
Were [the nursing care/the other health care/the medical equipment or supplies/the personal or home support/the other] services provided for yourself or someone else living in your household?
- 1: Home care provided to selected respondent only
- 2: Home care provided to other household member only
- 3: Home care provided to selected respondent and other household member
- 8: RF
- 9: DK
Home care services (HMC) - Question identifier:HMC_R015
For the next two questions please only report for the home care services provided for you.
Home care services (HMC) - Question identifier:HMC_Q015
How long [[have you/have other household members]] been receiving [the nursing care/the other health care/the medical equipment or supplies/the personal or home support/the other] services?
- 1: Less than 1 month
- 2: 1 month to less than 3 months
- 3: 3 months to less than 6 months
- 4: 6 months to less than 1 year
- 5: 1 year to 3 years
- 6: More than 3 years
- 8: RF
- 9: DK
Home care services (HMC) - Question identifier:HMC_Q020
In a typical month over the past 12 months, how much [[have you/have other household members]] paid for [the nursing care/the other health care/the medical equipment or supplies/the personal or home support/the other] services?
- 01: $0
- 02: $1 to less than $50
- 03: $50 to less than $100
- 04: $100 to less than $200
- 05: $200 to less than $300
- 06: $300 to less than $400
- 07: $400 to less than $1000
- 08: $1000 and more
- 98: RF
- 99: DK
Home care services (HMC) - Question identifier:HMC_Q025
Who paid for these services?
- 1: Out of your / their own pocket
- 2: Family or friend living in the same household
- 3: Someone living outside the household (e.g., family, friends, volunteer organization)
- 4: Insurance
- 5: Government
- 6: Other
- 8: RF
- 9: DK
Home care services (HMC) - Question identifier:HMC_Q030
Overall, how satisfied [[were you/were the other household members]] with the home care services received?
[[were you/were the other household members]]...?
- 1: Very satisfied
- 2: Somewhat satisfied
- 3: Neither satisfied nor dissatisfied
- 4: Somewhat dissatisfied
- 5: Very dissatisfied
- 8: RF
- 9: DK
Home care services (HMC) - Question identifier:HMC_Q035
What are the reasons why [[you were/the other household members were]] not satisfied?
- 1: Poor quality (i.e. concerns about provider competence, reliability of services, etc.)
- 2: Services did not address perceived needs
- 3: Services provided were insufficient
- 4: Long wait times to receive services
- 5: Other reason
- 8: RF
- 9: DK
Home care services (HMC) - Question identifier:HMC_Q040
During the past 12 months, was there ever a time when [you or anyone in your household] felt that home care services were needed but were not received?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Home care services (HMC) - Question identifier:HMC_Q045
Were these (home care) services needed for yourself or someone else living in your household?
- 1: Selected Respondent only
- 2: Other household member only
- 3: Selected respondent and other household member
- 8: RF
- 9: DK
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?
- 1: Nursing care (e.g., dressing changes, preparing
medications, V.O.N. visits) - 2: Other health care services (e.g., physiotherapy,
occupational or speech therapy, nutrition counselling) - 3: Medical equipment or supplies (e.g., wheelchair, pads for incontinence, help with using a ventilator or oxygen equipment)
- 4: Personal or home support (such as bathing, housekeeping, meal preparation)
- 5: Other services (such as transportation, meals-on-wheels)
- 8: RF
- 9: DK
Home care services (HMC) - Question identifier:HMC_Q055
Again, thinking of the most recent time, why didn't [[you/they]] get these services?
- 01: Not available in the area
- 02: Not available at time required (e.g., inconvenient hours)
- 03: Waiting time too long
- 04: Cost
- 05: Didn't get around to it / didn't bother
- 06: Didn't know where to go / call
- 07: Language barrier
- 08: Decided not to seek services
- 09: Doctor did not think it was necessary
- 10: Not eligible for home care
- 11: Still waiting for home care
- 12: Other
- 98: RF
- 99: DK
Home care services (HMC) - Question identifier:HMC_Q060
Where did [[you/they]] try to get these home care services?
- 1: A government Home Care Program (e.g., CLSC in Quebec, CCAC in Ontario, 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
- 8: RF
- 9: DK
Unmet health care needs (UCN)
Unmet health care needs (UCN) - Question identifier:UCN_Q005
During the past 12 months, was there ever a time when you felt that you needed health care, other than homecare services, but you did not receive it?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Unmet health care needs (UCN) - Question identifier:UCN_Q010
Thinking of the most recent time you felt this way, why didn't you get care?
- 01: Care not available in the area
- 02: Care not available at time required (e.g., doctor busy, away from office or no longer at that practice, inconvenient hours)
- 03: Do not have a regular health care provider
- 04: Waiting time too long
- 05: Appointment was cancelled
- 06: Felt would receive inadequate care
- 07: Cost
- 08: Decided not to seek care
- 09: Doctor didn't think it was necessary
- 10: Transportation issue
- 11: Other
- 98: RF
- 99: DK
Unmet health care needs (UCN) - Question identifier:UCN_Q015
Again, thinking of the most recent time, what was the type of care that was needed?
- 01: Treatment of a chronic physical health condition diagnosed by a health professional
- 02: Treatment of a chronic mental health condition diagnosed by a health professional
- 03: Treatment of an acute infectious disease (e.g., cold, flu and stomach flu)
- 04: Treatment of an acute physical condition (non-infectious)
- 05: Treatment of an acute mental health condition (e.g., acute stress reaction)
- 06: A regular check-up (including pre-natal care)
- 07: Care of an injury
- 08: Dental care
- 09: Medication / Prescription refill
- 10: Other
- 98: RF
- 99: DK
Unmet health care needs (UCN) - Question identifier:UCN_Q020
Did you actively try to obtain the health care that was needed?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Unmet health care needs (UCN) - Question identifier:UCN_Q025
Where did you try to get the service you were seeking?
- 1: A doctor's office
- 2: A hospital outpatient clinic
- 3: A community health centre [or CLSC]
- 4: A walk-in clinic
- 5: An emergency department or emergency room
- 6: Other
- 8: RF
- 9: DK
Labour force (LBF)
Labour force (LBF) - Question identifier:LBF_Q005A
Many of the following questions concern [your] activities last week. By last week, I mean the week beginning on ^REFBEGE, and ending ^REFENDE.
Last week, did you work at a job or business? (regardless of the number of hours)
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Labour force (LBF) - Question identifier:LBF_Q005B
Last week, did you have a job or business from which you were absent?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Labour force (LBF) - Question identifier:LBF_Q005C
What was the main reason you were absent from work last week?
- 01: Own illness or disability
- 02: Caring for own children
- 03: Caring for elder relative (60 years of age or older)
- 04: Maternity or parental leave
- 05: Other personal or family responsibilities
- 06: Vacation
- 07: Labour dispute (strike or lockout) (Employees only)
- 08: Temporary layoff due to business conditions (Employees only)
- 09: Seasonal layoff (Employees only)
- 10: Casual job, no work available (Employees only)
- 11: Work schedule (e.g., shift work) (Employees only)
- 12: Self-employed, no work available (Self-employed only)
- 13: Seasonal business (Excluding employees)
- 14: Other - Specify
- 98: RF
- 99: DK
Labour force (LBF) - Question identifier:LBF_R010
The next questions are about your current job or business.
Labour force (LBF) - Question identifier:LBF_Q010
Were you an employee or self-employed?
- 1: Employee
- 2: Self-employed
- 3: Working in a family business without pay
- 8: RF
- 9: DK
Labour force (LBF) - Question identifier:LBF_Q015A
What was the name of your business?
Long Answer Length = 50
Labour force (LBF) - Question identifier:LBF_Q015B
For whom did you work?
Long Answer Length = 50
Labour force (LBF) - Question identifier:LBF_Q015C
What kind of business, industry or service was this?
Long Answer Length = 50
Labour force (LBF) - Question identifier:LBF_Q020A
What was your work or occupation?
Long Answer Length = 50
Labour force (LBF) - Question identifier:LBF_Q020B
In this work, what were your main activities?
Long Answer Length = 50
Labour force (LBF) - Question identifier:LBF_Q025
On average, how many hours do you usually work per week?
Min = 0.0; Max = 168.0
Labour force (LBF) - Question identifier:LBF_Q030
Did you have more than one job or business last week?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Labour force (LBF) - Question identifier:LBF_Q035
On average, how many hours do you usually work per week at your other job(s)?
Min = 1; Max = 168
Loss of productivity (LOP)
Loss of productivity (LOP) - Question identifier:LOP_Q005
At any time during the past three months, did you work at a job or a business?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Loss of productivity (LOP) - Question identifier:LOP_Q010
What is the main reason that you have not worked at a job or business in the past three months?
- 01: Respondent's own chronic physical or mental health condition diagnosed by a health professional
- 02: Respondent's own injury (e.g., broken bone, bad cut, burn and sprain)
- 03: Respondent's own acute infectious disease (e.g., cold, flu and stomach flu)
- 04: Respondent's own acute physical condition (non-infectious)
- 05: Respondent's own acute mental health condition (e.g., acute stress reaction)
- 06: Caring for own children
- 07: Caring for elderly relatives (60 years or older)
- 08: Maternity, paternity or parental leave
- 09: Education, training or school
- 10: Temporary lay-off
- 11: Permanent lay-off
- 12: Strike or lockout
- 13: Retired
- 14: Other
- 98: RF
- 99: DK
Loss of productivity (LOP) - Question identifier:LOP_R015
The next questions are about absence from work because of your OWN health. Please include consultations with health professionals, but exclude absences because of the health of another person. If you work part-time or at your own business, think only of the days you should have been working.
Loss of productivity (LOP) - Question identifier:LOP_Q015
In the past three months, that is from ^DATETHREEMONTHSAGO to yesterday, have you missed any days at work because of a chronic health condition?
By this, we mean a long-term physical or mental health condition diagnosed by a health professional that has lasted or is expected to last 6 months or more.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Loss of productivity (LOP) - Question identifier:LOP_Q020
How many days of work have you missed because of a chronic condition?
Min = 1; Max = 90
Loss of productivity (LOP) - Question identifier:LOP_Q025
Which chronic condition was this?
- 01: Arthritis (e.g., rheumatoid arthritis, osteoarthritis, lupus and gout)
- 02: Osteoporosis
- 03: Cardiovascular disease (e.g., stroke and hypertension)
- 04: Kidney disease
- 05: Asthma
- 06: Chronic bronchitis, emphysema or chronic obstructive pulmonary disease (COPD)
- 07: Diabetes
- 08: Migraines
- 09: Back Problems
- 10: Cancer
- 11: Mental health conditions (e.g., depression, bipolar disorder, mania and schizophrenia)
- 12: Neurological conditions (e.g., Alzheimer disease, dementia, Parkinson's disease, multiple sclerosis, epilepsy and cerebral palsy; excluding spina bifida)
- 13: Congenital anomalies (e.g., spina bifida), chromosomal abnormalities (e.g., Down syndrome) and malformations of the heart or digestive system
- 14: Digestive diseases (e.g., Crohn's disease, celiac disease, irritable bowel syndrome, and stomach ulcers)
- 15: Infectious disease (e.g., HIV, tuberculosis, and hepatitis B and C)
- 16: Urinary incontinence
- 17: Eye and ear diseases (e.g., glaucoma)
- 18: Skin diseases (e.g., psoriasis)
- 19: Fibromyalgia, chronic fatigue syndrome or multiple chemical sensitivities
- 20: Other - Specify
- 98: RF
- 99: DK
Loss of productivity (LOP) - Question identifier:LOP_Q030
In the past three months, have you missed any days at work because of an injury such as a broken bone, a bad cut, a burn or a sprain?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Loss of productivity (LOP) - Question identifier:LOP_Q035
How many days of work have you missed (because of an injury)?
Min = 1; Max = 90
Loss of productivity (LOP) - Question identifier:LOP_R040
The next questions are about acute health conditions, which are diagnosed or undiagnosed short-term physical or mental health conditions that last less than 6 months.
Loss of productivity (LOP) - Question identifier:LOP_Q040
In the past three months, have you missed any days at work because of an acute infectious disease such as a cold, a flu, another respiratory infection or a stomach flu?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Loss of productivity (LOP) - Question identifier:LOP_Q045
Which infectious diseases caused you to miss work in the past three months?
- 1: Cold
- 2: Flu or influenza
- 3: Other respiratory infection
- 4: Stomach flu
- 5: Any other acute infectious disease
- 8: RF
- 9: DK
Loss of productivity (LOP) - Question identifier:LOP_Q050
How many days of work have you missed because of a cold?
Min = 1; Max = 90
Loss of productivity (LOP) - Question identifier:LOP_Q055
How many days of work have you missed because of a flu or influenza?
Min = 1; Max = 90
Loss of productivity (LOP) - Question identifier:LOP_Q060
How many days of work have you missed because of another respiratory infection such as pneumonia or acute bronchitis?
Min = 1; Max = 90
Loss of productivity (LOP) - Question identifier:LOP_Q065
How many days of work have you missed because of a stomach flu?
Min = 1; Max = 90
Loss of productivity (LOP) - Question identifier:LOP_Q070
How many days of work have you missed because of any other acute infectious disease?
Min = 1; Max = 90
Loss of productivity (LOP) - Question identifier:LOP_Q075
In the past three months, have you been absent from work because of any other acute, non-infectious physical condition, for example an injury, migraine headache, or bad back?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Loss of productivity (LOP) - Question identifier:LOP_Q080
How many days of work have you missed because of any other acute physical condition (non-infectious)?
Min = 1; Max = 90
Loss of productivity (LOP) - Question identifier:LOP_Q085
In the past three months, have you been absent from work because of an acute mental health condition (for example acute stress reaction)?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Loss of productivity (LOP) - Question identifier:LOP_Q090
How many days of work have you missed because of an acute mental health condition?
Min = 1; Max = 90
Socio-demographic characteristics (SDC)
Socio-demographic characteristics (SDC) - Question identifier:SDC_R001
Now, some general background questions which will help us compare the health of people in Canada.
Socio-demographic characteristics (SDC) - Question identifier:SDC_Q005
In what country were you born?
- 1: Search
- 3: Other - Specify
- 8: RF
- 9: DK
Socio-demographic characteristics (SDC) - Question identifier:SDC_Q006
In which province or territory were you born?
- 10: Newfoundland and Labrador
- 11: Prince Edward Island
- 12: Nova Scotia
- 13: New Brunswick
- 24: Quebec
- 35: Ontario
- 46: Manitoba
- 47: Saskatchewan
- 48: Alberta
- 59: British Columbia
- 60: Yukon
- 61: Northwest Territories
- 62: Nunavut
- 98: RF
- 99: DK
Socio-demographic characteristics (SDC) - Question identifier:SDC_Q007
Are you now, or have you ever been a landed immigrant in Canada?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Socio-demographic characteristics (SDC) - Question identifier:SDC_Q008
In what year did you first become a landed immigrant in Canada?
Min = 1870; Max = 2100
Socio-demographic characteristics (SDC) - Question identifier:SDC_Q010
To which ethnic or cultural groups did your ancestors belong? (For example: French, Scottish, Chinese, East Indian)
- 01: Canadian
- 02: French
- 03: English
- 04: German
- 05: Scottish
- 06: Irish
- 07: Italian
- 08: Ukrainian
- 09: Dutch (Netherlands)
- 10: Chinese
- 11: Jewish
- 12: Polish
- 13: Portuguese
- 14: South Asian (e.g., East Indian, Pakistani, Sri Lankan)
- 15: Norwegian
- 16: Welsh
- 17: Swedish
- 18: First Nations (North American Indian)
- 19: Métis
- 20: Inuit
- 21: Other - Specify
- 98: RF
- 99: DK
Socio-demographic characteristics (SDC) - Question identifier:SDC_Q015
Are you an Aboriginal person, that is, First Nations, Métis or Inuk (Inuit)? First Nations includes Status and Non-Status Indians.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Socio-demographic characteristics (SDC) - Question identifier:SDC_Q016
Are you First Nations, Métis or Inuk (Inuit)?
- 1: First Nations (North American Indian)
- 2: Métis
- 3: Inuk (Inuit)
- 8: RF
- 9: DK
Socio-demographic characteristics (SDC) - Question identifier:SDC_Q020
You may belong to one or more racial or cultural groups on the following list. Are you... ?
- 01: White
- 02: South Asian (e.g., East Indian, Pakistani, Sri Lankan)
- 03: Chinese
- 04: Black
- 05: Filipino
- 06: Latin American
- 07: Arab
- 08: Southeast Asian (e.g., Vietnamese, Cambodian,
Malaysian, Laotian) - 09: West Asian (e.g., Iranian, Afghan)
- 10: Korean
- 11: Japanese
- 12: Other - Specify
- 98: RF
- 99: DK
Socio-demographic characteristics (SDC) - Question identifier:SDC_Q025
Of English or French, which language(s) do you speak well enough to conduct a conversation? Is it... ?
- 1: English only
- 2: French only
- 3: Both English and French
- 4: Neither English nor French
- 8: RF
- 9: DK
Socio-demographic characteristics (SDC) - Question identifier:SDC_Q026
What language do you speak most often at home?
Long Answer Length = 80
Socio-demographic characteristics (SDC) - Question identifier:SDC_Q027
What is the language that you first learned at home in childhood and still understand?
Long Answer Length = 80
Socio-demographic characteristics (SDC) - Question identifier:SDC_R030
Now a question about the dwelling in which you live.
Socio-demographic characteristics (SDC) - Question identifier:SDC_Q030
Is this dwelling...?
- 1: Owned by you or a member of this household, even if it is still being paid for
- 2: Rented, even if no cash rent is paid
- 8: RF
- 9: DK
Socio-demographic characteristics (SDC) - Question identifier:SDC_R035
Now, one additional background question which will help us compare the health of people in Canada.
Socio-demographic characteristics (SDC) - Question identifier:SDC_Q035
Do you consider yourself to be...?
- 1: Heterosexual (sexual relations with people of the opposite sex)
- 2: Homosexual, that is lesbian or gay (sexual relations with people of your own sex)
- 3: Bisexual (sexual relations with people of both sexes)
- 8: RF
- 9: DK
Person most knowledgeable about household situation (PMK)
Person most knowledgeable about household situation (PMK) - Question identifier:PMK_R005A
To avoid duplication of surveys, Statistics Canada has signed agreements with provincial and territorial ministries of health, Health Canada and the Public Health Agency of Canada to share the information that you provided on this survey.
Provincial ministries of health may make this information available to local health authorities, but no identifiable information such as names, addresses or telephone numbers will be provided.
Person most knowledgeable about household situation (PMK) - Question identifier:PMK_R005B
To avoid duplication of surveys, Statistics Canada has signed agreements with provincial and territorial ministries of health, Health Canada and the Public Health Agency of Canada to share the information that you provided on this survey.
Territorial ministries of health may make this information available to local health authorities, but no identifiable information such as names, addresses, telephone numbers or health numbers will be provided.
Person most knowledgeable about household situation (PMK) - Question identifier:PMK_R005C
To avoid duplication of surveys, Statistics Canada has signed agreements with provincial and territorial ministries of health, the " Institut de la Statistique du Québec ", Health Canada and the Public Health Agency of Canada to share the information that you provided on this survey.
The " Institut de la Statistique du Québec " and provincial ministries of health may make this information available to local health authorities, but no identifiable information such as names, addresses or telephone numbers will be provided.
Person most knowledgeable about household situation (PMK) - Question identifier:PMK_Q005
These organizations have agreed to keep your information confidential and use it only for statistical purposes.
Do you agree to share the information provided?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Person most knowledgeable about household situation (PMK) - Question identifier:PMK_R010
For the last few questions, I would like to speak with someone who would be best able to answer questions about the entire household such as household income and food purchases.
Person most knowledgeable about household situation (PMK) - Question identifier:PMK_Q010
Who would this person be?
- 01: MEMBER1
- 02: MEMBER2
- 03: MEMBER3
- 04: MEMBER4
- 05: MEMBER5
- 06: MEMBER6
- 07: MEMBER7
- 08: MEMBER8
- 09: MEMBER9
- 10: MEMBER10
- 11: MEMBER11
- 12: MEMBER12
- 13: MEMBER13
- 14: MEMBER14
- 15: MEMBER15
- 16: MEMBER16
- 17: MEMBER17
- 18: MEMBER18
- 19: MEMBER19
- 20: MEMBER20
Person most knowledgeable about household situation (PMK) - Question identifier:PMK_Q015
Is [MEMBER#] available?
- 1: Yes
- 2: No
- 3: Person most knowledgeable about household refuses to participate.
Person most knowledgeable about household situation (PMK) - Question identifier:PMK_R025
This completes your portion of the interview. On behalf of Statistics Canada, I would like to thank you very much for your time.
Person most knowledgeable about household situation (PMK) - Question identifier:PMK_R030
This completes your portion of the interview. On behalf of Statistics Canada, I would like to thank you very much for your time. I would now like to try and find the best time to speak with [MEMBER#].
Person most knowledgeable about household situation (PMK) - Question identifier:PMK_R035
This completes your portion of the interview. On behalf of Statistics Canada, I would like to thank you very much for your time. I would now like to speak with ^MEMBERNAME.
Person most knowledgeable about household situation (PMK) - Question identifier:PMK_R040
Hello, My name is... I've just completed the main portion of the interview with <Respondent's name>. At this point I need to finish the interview with a few general questions on your household's situation. <Respondent's name> said you would be the best person to answer these types of questions.
Health insurance coverage (INS)
Health insurance coverage (INS) - Question identifier:INS_R001
Now, turning to [your] health insurance coverage. Please include any private, government or employer-paid plans.
Health insurance coverage (INS) - Question identifier:INS_Q005
[Do you] have insurance that covers all or part of the cost of [your] prescription medications?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health insurance coverage (INS) - Question identifier:INS_Q010
Is it...?
- 1: A government-sponsored plan
- 2: An employer-sponsored benefit plan
- 3: A plan sponsored through an association such as a union, trade association or student organization
- 4: Other, such as your own private plan purchased from an insurance company
- 8: RF
- 9: DK
Health insurance coverage (INS) - Question identifier:INS_Q015
[Do you] have insurance that covers all or part of [your] long-term care costs, including home care?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health insurance coverage (INS) - Question identifier:INS_Q020
Is it...?
- 1: A government-sponsored plan
- 2: An employer-sponsored benefit plan
- 3: A plan sponsored through an association such as a union, trade association or student organization
- 4: Other, such as your own private plan purchased from an insurance company
- 8: RF
- 9: DK
Food security (FSC)
Food security (FSC) - Question identifier:FSC_R010
The following questions are about the food situation for your household in the past 12 months. I'm going to read you several statements that may be used to describe the food situation for a household. Please tell me if the statement was often true, sometimes true, or never true for [you and other household members] in the past 12 months.
Food security (FSC) - Question identifier:FSC_Q010
The first statement is: [You and other household members] worried that food would run out before you got money to buy more. Was that often true, sometimes true, or never true in the past 12 months?
- 1: Often true
- 2: Sometimes true
- 3: Never true
- 8: RF
- 9: DK
Food security (FSC) - Question identifier:FSC_Q015
The food that [you and other household members] bought just didn't last, and there wasn't any money to get more. Was that often true, sometimes true, or never true in the past 12 months?
- 1: Often true
- 2: Sometimes true
- 3: Never true
- 8: RF
- 9: DK
Food security (FSC) - Question identifier:FSC_Q020
[You and other household members] couldn't afford to eat balanced meals. In the past 12 months was that often true, sometimes true, or never true?
- 1: Often true
- 2: Sometimes true
- 3: Never true
- 8: RF
- 9: DK
Food security (FSC) - Question identifier:FSC_R025
Now, I'm going to read a few statements that may describe the food situation for households with children.
Food security (FSC) - Question identifier:FSC_Q025
[You or other adults in your household] relied on only a few kinds of low-cost food to feed [the children] because you were running out of money to buy food. Was that often true, sometimes true, or never true in the past 12 months?
- 1: Often true
- 2: Sometimes true
- 3: Never true
- 8: RF
- 9: DK
Food security (FSC) - Question identifier:FSC_Q030
[You or other adults in your household] couldn't feed [the children] a balanced meal, because you couldn't afford it. Was that often true, sometimes true, or never true in the past 12 months?
- 1: Often true
- 2: Sometimes true
- 3: Never true
- 8: RF
- 9: DK
Food security (FSC) - Question identifier:FSC_Q035
[The children were] not eating enough because [you or other adults in your household] just couldn't afford enough food. Was that often, sometimes, or never true in the past 12 months?
- 1: Often true
- 2: Sometimes true
- 3: Never true
- 8: RF
- 9: DK
Food security (FSC) - Question identifier:FSC_R040
The following few questions are about the food situation in the past 12 months for you or any other adults in your household.
Food security (FSC) - Question identifier:FSC_Q040
In the past 12 months, since last ^CURRENTMONTH, did [you or other adults in your household] ever cut the size of your meals or skip meals because there wasn't enough money for food?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Food security (FSC) - Question identifier:FSC_Q045
How often did this happen? Was it...?
- 1: Almost every month
- 2: Some months but not every month
- 3: Only 1 or 2 months
- 8: RF
- 9: DK
Food security (FSC) - Question identifier:FSC_Q050
In the past 12 months, did you (personally) ever eat less than you felt you should because there wasn't enough money to buy food?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Food security (FSC) - Question identifier:FSC_Q055
In the past 12 months, were you (personally) ever hungry but didn't eat because you couldn't afford enough food?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Food security (FSC) - Question identifier:FSC_Q060
In the past 12 months, did you (personally) ever lose weight because you didn't have enough money for food?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Food security (FSC) - Question identifier:FSC_Q065
In the past 12 months, did [you or other adults in your household] ever not eat for a whole day because there wasn't enough money for food?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Food security (FSC) - Question identifier:FSC_Q070
How often did this happen? Was it...?
- 1: Almost every month
- 2: Some months but not every month
- 3: Only 1 or 2 months
- 8: RF
- 9: DK
Food security (FSC) - Question identifier:FSC_R075
Now, a few questions on the food experiences for children in your household.
Food security (FSC) - Question identifier:FSC_Q075
In the past 12 months, did [you or other adults in your household] ever cut the size of [any of the children's] meals because there wasn't enough money for food?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Food security (FSC) - Question identifier:FSC_Q080
In the past 12 months, did [any of the children] ever skip meals because there wasn't enough money for food?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Food security (FSC) - Question identifier:FSC_Q085
How often did this happen? Was it...?
- 1: Almost every month
- 2: Some months but not every month
- 3: Only 1 or 2 months
- 8: RF
- 9: DK
Food security (FSC) - Question identifier:FSC_Q090
In the past 12 months, [were any of the children] ever hungry but you just couldn't afford more food?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Food security (FSC) - Question identifier:FSC_Q095
In the past 12 months, did [any of the children] ever not eat for a whole day because there wasn't enough money for food?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Administration information (ADM)
Administration information (ADM) - Question identifier:ADM_R001
Although many health expenses are covered by health insurance, there is still an important relationship between health and income. Please be assured that, like all other information you have provided, these answers will be kept strictly confidential.
Administration information (ADM) - Question identifier:ADM_Q005
Thinking about the total income for all household members, from which of the following sources did your household receive any income in the year ending December 31, ^DV_PASTYEAR?
- 01: Wages and salaries
- 02: Income from self-employment
- 03: Dividends and interest (e.g., on bonds, savings)
- 04: Employment insurance
- 05: Worker's compensation
- 06: Benefits from Canada or Quebec Pension Plan
- 07: Job related retirement pensions, superannuation and annuities
- 08: RRSP/RRIF (Registered Retirement Savings Plan/Registered Retirement Income Fund)
- 09: Old Age Security and Guaranteed Income Supplement
- 10: Provincial or municipal social assistance or welfare
- 11: Child Tax Benefit
- 12: Child support
- 13: Alimony
- 14: Other (e.g., rental income, scholarships)
- 15: None
- 98: RF
- 99: DK
Administration information (ADM) - Question identifier:ADM_Q010
Does this amount include a supplement for people with disabilities?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Administration information (ADM) - Question identifier:ADM_Q015
What was the main source of household income?
- 01: Wages and salaries
- 02: Income from self-employment
- 03: Dividends and interest (e.g., on bonds, savings)
- 04: Employment insurance
- 05: Worker's compensation
- 06: Benefits from Canada or Quebec Pension Plan
- 07: Job related retirement pensions, superannuation and annuities
- 08: RRSP/RRIF (Registered Retirement Savings Plan/Registered Retirement Income Fund)
- 09: Old Age Security and Guaranteed Income Supplement
- 10: Provincial or municipal social assistance or welfare
- 11: Child Tax Benefit
- 12: Child support
- 13: Alimony
- 14: Other (e.g., rental income, scholarships)
- 15: None
- 98: RF
- 99: DK
Administration information (ADM) - Question identifier:ADM_Q020A
Now a question about your total household income.
What is your best estimate of your total household income received by all household members, from all sources, before taxes and deductions, during the year ending December 31, ^DV_PASTYEAR?
Income can come from various sources such as from work, investments, pensions or government. Examples include Employment Insurance, Social Assistance, Child Tax Benefit and other income such as child support, spousal support (alimony) and rental income.
Min = -9000000; Max = 90000000
Administration information (ADM) - Question identifier:ADM_Q020B
Can you estimate in which of the following groups your household income falls? Was the total household income during the year ending December 31, ^DV_PASTYEAR... ?
- 1: Less than $50,000 including income loss
- 2: $50,000 and more
- 8: RF
- 9: DK
Administration information (ADM) - Question identifier:ADM_Q020C
Please stop me when I have read the category which applies to your household.
Was it... ?
- 1: Less than $5,000
- 2: $5,000 to less than $10,000
- 3: $10,000 to less than $15,000
- 4: $15,000 to less than $20,000
- 5: $20,000 to less than $30,000
- 6: $30,000 to less than $40,000
- 7: $40,000 to less than $50,000
- 8: RF
- 9: DK
Administration information (ADM) - Question identifier:ADM_Q020D
Please stop me when I have read the category which applies to your household.
Was it... ?
- 1: $50,000 to less than less than $60,000
- 2: $60,000 to less than less than $70,000
- 3: $70,000 to less than less than $80,000
- 4: $80,000 to less than less than $90,000
- 5: $90,000 to less than less than $100,000
- 6: $100,000 to less than less than $150,000
- 7: $150,000 and over
- 8: RF
- 9: DK
Administration information (ADM) - Question identifier:ADM_Q025
Thinking about your total personal income, from which of the following sources did you receive any income in the year ending December 31, ^DV_PASTYEAR?
- 01: Wages and salaries
- 02: Income from self-employment
- 03: Dividends and interest (e.g., on bonds, savings)
- 04: Employment insurance
- 05: Worker's compensation
- 06: Benefits from Canada or Quebec Pension Plan
- 07: Job related retirement pensions, superannuation and annuities
- 08: RRSP/RRIF (Registered Retirement Savings Plan/Registered Retirement Income Fund)
- 09: Old Age Security and Guaranteed Income Supplement
- 10: Provincial or municipal social assistance or welfare
- 11: Child Tax Benefit
- 12: Child support
- 13: Alimony
- 14: Other (e.g., rental income, scholarships)
- 15: None
- 98: RF
- 99: DK
Administration information (ADM) - Question identifier:ADM_Q030
Does this amount include a supplement for people with disabilities?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Administration information (ADM) - Question identifier:ADM_Q035
What was the main source of your personal income?
- 01: Wages and salaries
- 02: Income from self-employment
- 03: Dividends and interest (e.g., on bonds, savings)
- 04: Employment insurance
- 05: Worker's compensation
- 06: Benefits from Canada or Quebec Pension Plan
- 07: Job related retirement pensions, superannuation and annuities
- 08: RRSP/RRIF (Registered Retirement Savings Plan/Registered Retirement Income Fund)
- 09: Old Age Security and Guaranteed Income Supplement
- 10: Provincial or municipal social assistance or welfare
- 11: Child Tax Benefit
- 12: Child support
- 13: Alimony
- 14: Other (e.g., rental income, scholarships)
- 15: None
- 98: RF
- 99: DK
Administration information (ADM) - Question identifier:ADM_Q040A
Now a question about your total personal income.
What is your best estimate of your total personal income, before taxes and deductions, from all sources during the year ending December 31, ^DV_PASTYEAR?
Income can come from various sources such as from work, investments, pensions or government. Examples include Employment Insurance, Social Assistance, Child Tax Benefit and other income such as child support, spousal support (alimony) and rental income.
Min = -9000000; Max = 90000000
Administration information (ADM) - Question identifier:ADM_Q040B
Can you estimate in which of the following groups your personal income falls? Was your total personal income during the year ending December 31, ^DV_PASTYEAR... ?
- 1: Less than $30,000 including income loss
- 2: $30,000 and more
- 8: RF
- 9: DK
Administration information (ADM) - Question identifier:ADM_Q040C
Please stop me when I have read the category which applies to you.
Was it... ?
- 1: Less than $5,000
- 2: $5,000 to less than $10,000
- 3: $10,000 to less than $15,000
- 4: $15,000 to less than $20,000
- 5: $20,000 to less than $25,000
- 6: $25,000 to less than $30,000
- 8: RF
- 9: DK
Administration information (ADM) - Question identifier:ADM_Q040D
Please stop me when I have read the category which applies to you.
Was it... ?
- 01: $30,000 to less than $40,000
- 02: $40,000 to less than $50,000
- 03: $50,000 to less than $60,000
- 04: $60,000 to less than $70,000
- 05: $70,000 to less than $80,000
- 06: $80,000 to less than $90,000
- 07: $90,000 to less than $100,000
- 08: $100,000 and over
- 98: RF
- 99: DK
Administration information (ADM) - Question identifier:ADM_Q045
Having a provincial or territorial health number will assist us in linking to this other information.
^DT_DOYOU2 have a provincial or territorial health number?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Administration information (ADM) - Question identifier:ADM_Q050
For which province or territory is ^DT_YOUR1 health number?
- 10: Newfoundland and Labrador
- 11: Prince Edward Island
- 12: Nova Scotia
- 13: New Brunswick
- 24: Quebec
- 35: Ontario
- 46: Manitoba
- 47: Saskatchewan
- 48: Alberta
- 59: British Columbia
- 60: Yukon
- 61: Northwest Territories
- 62: Nunavut
- 88: Does not have a Canadian health number
- 98: RF
- 99: DK
Administration information (ADM) - Question identifier:ADM_Q055
What is ^DT_YOUR1 health number?
Long Answer Length = 50
Sexual behaviours (SXB)
Sexual behaviours (SXB) - Question identifier:SXB_R001
The next set of questions is about sexual behaviours and is voluntary, but your answers will help in the monitoring of important public health issues, such as risk of sexually transmitted infections and unintended pregnancies.
Sexual behaviours (SXB) - Question identifier:SXB_Q005
Have you ever had sex? Please include vaginal and anal sex.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Sexual behaviours (SXB) - Question identifier:SXB_Q010
During your lifetime, have you had sex with...?
- 1: Males only
- 2: Females only
- 3: Both males and females
- 8: RF
- 9: DK
Sexual behaviours (SXB) - Question identifier:SXB_Q015
How old were you the first time you had sex with a female?
Min = 1; Max = 121
Sexual behaviours (SXB) - Question identifier:SXB_Q020
How old was your (female) partner the first time you had sex?
Min = 1; Max = 121
Sexual behaviours (SXB) - Question identifier:SXB_Q025
Did you or your (female) partner use a condom the first time (you had sex)?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Sexual behaviours (SXB) - Question identifier:SXB_Q030
In the past 12 months, have you had sex with a female?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Sexual behaviours (SXB) - Question identifier:SXB_Q035
With how many different (female) partners?
Min = 1; Max = 500
Sexual behaviours (SXB) - Question identifier:SXB_Q040
How old was your (female) partner the last time (you had sex)?
Min = 1; Max = 121
Sexual behaviours (SXB) - Question identifier:SXB_Q045
How old were you the first time you had sex with a male?
Min = 1; Max = 121
Sexual behaviours (SXB) - Question identifier:SXB_Q050
How old was your (male) partner the first time you had sex?
Min = 1; Max = 121
Sexual behaviours (SXB) - Question identifier:SXB_Q055
Did you or your (male) partner use a condom the first time (you had sex)?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Sexual behaviours (SXB) - Question identifier:SXB_Q060
In the past 12 months, have you had sex with a male?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Sexual behaviours (SXB) - Question identifier:SXB_Q065
With how many different (male) partners?
Min = 1; Max = 500
Sexual behaviours (SXB) - Question identifier:SXB_Q070
How old was your (male) partner the last time (you had sex)?
Min = 1; Max = 121
Sexual behaviours (SXB) - Question identifier:SXB_Q075
Was your last sex partner a male or female?
- 1: Male
- 2: Female
- 3: Both male and female (at same time)
- 8: RF
- 9: DK
Sexual behaviours (SXB) - Question identifier:SXB_Q080
Did you or your partner use a condom the last time you had sex?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Sexual behaviours (SXB) - Question identifier:SXB_Q085
What are the reasons that you or your partner used a condom the last time you had sex? Was this...?
- 1: To protect against sexually transmitted infections, including HIV
- 2: To prevent pregnancy
- 3: Both to protect against sexually transmitted infections and to prevent pregnancy
- 4: Other - Specify
- 8: RF
- 9: DK
Sexual behaviours (SXB) - Question identifier:SXB_Q090
What are the reasons that you or your partner did NOT use a condom the last time you had sex?
- 01: I was or my partner was trying to get pregnant
- 02: I was or my partner was already pregnant
- 03: Did not think we were at risk of pregnancy
- 04: Did not think we were at risk of sexually transmitted infections, including HIV
- 05: I was in a monogamous relationship
- 06: Did not have a condom or other protection at the time
- 07: We used another method of protection
- 08: We didn't like condoms
- 09: Other - Specify
- 98: RF
- 99: DK
Sexual behaviours (SXB) - Question identifier:SXB_Q095
What other methods of protection did you and your partner use the last time you had sex?
- 01: Withdrawal or pulling out
- 02: Vasectomy or tubal sterilization ("tubes tied")
- 03: Birth control pill
- 04: Injection (e.g., Depo-Provera)
- 05: Spermicidal foam, jelly, cream, film, suppository
- 06: Hormonal implant
- 07: Rhythm method (tracking ovulation cycle)
- 08: Contraceptive Patch (e.g., Ortho-Evra)
- 09: Vaginal contraceptive ring (e.g., Nuva-ring)
- 10: Intrauterine Device (IUD) (e.g., Mirena), coil, loop
- 11: None
- 12: Other - Specify
- 98: RF
- 99: DK
Sexual behaviours (SXB) - Question identifier:SXB_Q100
In the past 12 months, did you use the emergency contraceptive pill?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Sexual behaviours (SXB) - Question identifier:SXB_Q105
How many times (did you use the emergency contraceptive pill in the past 12 months)?
- 1: Once
- 2: Twice
- 3: More than twice
- 8: RF
- 9: DK
Sexual behaviours (SXB) - Question identifier:SXB_Q110
Have you ever had a test for HIV, other than for blood donation?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Sexual behaviours (SXB) - Question identifier:SXB_Q115
When was your most recent HIV test?
- 1: Within the past month
- 2: From 1 to less than 6 months ago
- 3: From 6 to less than 12 months ago
- 4: One year ago or more
- 8: RF
- 9: DK
Sexual behaviours (SXB) - Question identifier:SXB_Q120
What was the main reason you had this test for HIV? Was this for...?
- 1: Insurance policy requirement
- 2: Mandatory screening for immigration
- 3: [Prenatal screening]
- 4: New partner
- 5: Concern for my health
- 6: Other
- 8: RF
- 9: DK
Sexual behaviours (SXB) - Question identifier:SXB_Q125
Did you obtain the result for this test?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Sexual behaviours (SXB) - Question identifier:SXB_Q130
Have you ever been tested for sexually transmitted infections, other than HIV?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Sexual behaviours (SXB) - Question identifier:SXB_Q135
When was your most recent test for sexually transmitted infections (STI), other than HIV?
- 1: Within the past month
- 2: From 1 to less than 6 months ago
- 3: From 6 to less than 12 months ago
- 4: One year ago or more
- 8: RF
- 9: DK
Sexual behaviours (SXB) - Question identifier:SXB_Q140
What was the main reason you had this test for sexually transmitted infections (STI), other than HIV? Was this for...?
- 1: Insurance policy requirement
- 2: Mandatory screening for immigration
- 3: [Prenatal screening]
- 4: New partner
- 5: Concern for my health
- 6: Other
- 8: RF
- 9: DK
Sexual behaviours (SXB) - Question identifier:SXB_Q145
Did you obtain the result for this test?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
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