Questionnaires
Questionnaires were administered to NNYFS participants both at home and in the mobile examination center (MEC). The questionnaires can be viewed using Adobe Acrobat readerExternal
Screener Module
Screener Module Cdc-pdf[PDF – 133 KB] – This is administered on the doorstep. This set of questions determines if anyone in the household is eligible to be in the sample.
Family Questionnaire
Sample Person Questionnaire
- Acculturation Cdc-pdf[PDF – 28 KB]
- Demographics Cdc-pdf[PDF – 36 KB]
- Diabetes Cdc-pdf[PDF – 17 KB]
- Diet Behavior and Nutrition Cdc-pdf[PDF – 23 KB]
- Dietary Supplements and Prescription Medication Cdc-pdf[PDF – 104 KB]
- Early Childhood Cdc-pdf[PDF – 15 KB]
- Health Insurance Cdc-pdf[PDF – 14 KB]
- Hospital Utilization and Access to Care Cdc-pdf[PDF – 14 KB]
- Medical Conditions Cdc-pdf[PDF – 18 KB]
- Physical Activity Cdc-pdf[PDF – 76 KB]
- Physical Functioning Cdc-pdf[PDF – 15 KB]
- Respiratory Health and Disease Cdc-pdf[PDF – 11 KB]
MEC CASI and CAPI Questionnaires
Computer assisted personal self interview (CASI) 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.
Computer Assisted Personal Self Interview (CASI) Questionnaire
Computer Assisted Personal Interview (CAPI) Questionnaire
Page last reviewed: November 6, 2015
Content source: National Center for Health Statistics