Survey Questionnaires, Examination Components and Laboratory Components 2007-2008
On this Page
- Questionnaires
- Screener Modules
- Family Questionnaire
- Sample Person Questionnaire
- MEC ACASI and CAPI Questionnaires
- Audio Computer Assisted Personal Self Interview (ACASI) Questionnaire
- Computer Assisted Personal Interview (CAPI) Questionnaire
- Special Follow-up Questionnaires
- Examination and Laboratory
The Questionnaires and Exam Components can be viewed using Adobe Acrobat reader.
Questionnaires
Questionnaires are administered to NHANES participants both at home and in the trailers. The questionnaires and a brief description of each section follows.
Screener Modules
- Screener Module 1 [PDF - 188 KB]. This is administered on the doorstep. This set of questions determines if anyone in the household is eligible to be in the sample.
- Screener Module 1 (Spanish) [PDF - 121 KB] This is the same module in Spanish.
- Screener Module 2 [PDF - 203 KB]. This establishes the relationship of everyone in the household to everyone else in the household.
- Screener Module 2 (Spanish) [PDF - 135 KB] This is the same module in Spanish.
Family Questionnaire
Household and family level information is collected here. The sections are labeled to reflect content.
- Family Questionnaire Hand Cards [PDF - 73 KB]
- Demographic Background/Occupation [PDF - 76 KB]
- Housing Characteristics [PDF - 71 KB]
- Income [PDF - 220 KB]
- Smoking [PDF - 68 KB]
- Consumer Behavior [PDF - 75 KB]
- Food Security [PDF - 111 KB]
- Tracking and Tracing [PDF - 81 KB]
Sample Person Questionnaire
Individual level information on participants is collected here. The sections are labeled to reflect content. Please note that the Medical Conditions section covers many subject areas.
- Sample Person Questionnaire Hand Cards [PDF - 504 KB]
- Acculturation [PDF - 106 KB]
- Audiometry [PDF - 152 KB]
- Blood Pressure [PDF - 135 KB]
- Cardiovascular Disease [PDF - 117 KB]
- Demographics Information [PDF - 203 KB]
- Dermatology [PDF - 33 KB]
- Diabetes [PDF - 183 KB]
- Dietary Supplements and Prescription Medication [PDF - 354 KB]
- Dietary Behavior [PDF - 195 KB]
- Early Childhood [PDF - 130 KB]
- Health Insurance [PDF - 141 KB]
- Hospital Utilization and Access to Care [PDF - 129 KB]
- Immunization [PDF - 112 KB]
- Kidney Conditions [PDF - 109 KB]
- Medical Conditions [PDF - 237 KB]
- Occupation [PDF - 107 KB]
- Oral Health [PDF - 133 KB]
- Osteoporosis [PDF - 161 KB]
- Physical Activity and Physical Fitness [PDF - 148 KB]
- Physical Functioning [PDF - 160 KB]
- Respiratory Health and Disease [PDF - 132 KB]
- Sleep Disorders [PDF - 192 KB]
- Smoking and Tobacco Use [PDF - 152 KB]
- Social Support [PDF - 124 KB]
- Vision [PDF - 162 KB]
- Weight History [PDF - 182 KB]
MEC ACASI and CAPI Questionnaires
Audio computer assisted personal self interview (ACASI) and computer assisted personal interview (CAPI) questionnaires are administered in the MEC. During the visit to the examination center additional questions are administered that cover more sensitive areas such as reproductive health and illegal drug use. The sections are labeled to reflect content.
Audio Computer Assisted Personal Self Interview (ACASI) Questionnaire
- Alcohol Use [PDF - 46 KB]
- Drugs Use [PDF - 101 KB]
- Food Security [PDF - 46 KB]
- Sexual Behavior [PDF - 77 KB]
- Tobacco Use [PDF - 100 KB]
Computer Assisted Personal Interview (CAPI) Questionnaire
- MEC CAPI Questionnaire Hand Cards [PDF - 495 KB]
- Alcohol Use [PDF - 40 KB]
- Bowel Health [PDF - 62 KB]
- Current Health Status [PDF - 50 KB]
- Depression Screen [PDF - 74 KB]
- Kidney [PDF - 75 KB]
- Pesticide Use [PDF - 31 KB]
- Physical Activity [PDF - 55 KB]
- Reproductive Health [PDF - 177 KB]
- Respondent Information [PDF - 50 KB]
- Tobacco [PDF - 61 KB]
- Volatile Toxicants Use [PDF - 51 KB]
- Weight History [PDF - 75 KB]
Special Follow-up Questionnaires
- Flexible Consumer Behavior Survey (FCBS) Module [PDF - 282 KB]
- NHANES Hepatitis C Follow-up [PDF - 365 KB]
Examination and Laboratory
- Dietary Recall [PDF - 203 KB]
- Measuring Guides for the Dietary Recall Interview
- 24-Hour Dietary Supplement and Antacids Use [PDF - 169 KB]
- Examination Components [PDF - 1 MB] consist of the following:
- Audiometry
- Body Composition
- Body Measurements
- Cardiovascular Fitness
- Ophthalmology
- Oral Health
- Physical Activity Monitor
- Physician's Exam
- Vision
- Laboratory Components [PDF - 358 KB] consist of the following:
- Blood & Urine
- Venipuncture
- Urine Collection
- Bone Markers
- Diabetes Profile
- Infectious Disease Profile
- Miscellaneous Laboratory Assays
- Kidney Disease Profile
- Nutritional Biochemistries and Hematologies
- Sexually Transmitted Disease Profile
- Tobacco Use
- Blood lipids
- Environmental Health Profile [PDF - 154 KB]
Contact Us:
- National Center for Health Statistics
3311 Toledo Rd
Room 5419
Hyattsville, MD 20782 - 1 (800) 232-4636
- Contact CDC–INFO
