Questionnaires 2012 Modules By State
| State | Module(s) |
|---|---|
| Alabama | Adult Human Papilloma Virus (HPV), Cancer Survivorship, Childhood Asthma Prevalence, Diabetes, General Preparedness, Pre-Diabetes, Random Child Selection |
| Alaska | Cancer Survivorship, Diabetes, Inadequate Sleep, Pre-Diabetes |
| Arizona | Adult Human Papilloma Virus (HPV), Childhood Asthma Prevalence, Childhood Immunization, Chronic Obstructive Pulmonary Disease (COPD), Fruits and Vegetables, Random Child Selection, Reactions to Race, Shingles (Zostavax or ZOS), Tetanus Diphtheria (Adults) |
| Arkansas | Diabetes, Pre-Diabetes |
| California | Childhood Asthma Prevalence, Random Child Selection |
| Colorado | Excess Sun Exposure |
| Connecticut | Adult Human Papilloma Virus (HPV), Childhood Asthma Prevalence, Childhood Immunization, Chronic Obstructive Pulmonary Disease (COPD), Diabetes, HIV/AIDS, Pre-Diabetes, Random Child Selection, Shingles (Zostavax or ZOS) |
| Delaware | Adult Human Papilloma Virus (HPV), Diabetes, Fruits and Vegetables, Pre-Diabetes, Prostate Cancer Screening Decision Making Module, Sugar Sweetened Beverages and Menu Labeling |
| District of Columbia | Childhood Asthma Prevalence, Random Child Selection |
| Georgia | Cancer Survivorship, Childhood Asthma Prevalence, Diabetes, Fruits and Vegetables, Pre-Diabetes, Prostate Cancer Screening Decision Making Module, Random Child Selection, Sugar Sweetened Beverages and Menu Labeling |
| Guam | Diabetes, Pre-Diabetes |
| Hawaii | Cancer Survivorship, Childhood Asthma Prevalence, Childhood Immunization, Diabetes, Excess Sun Exposure, Pre-Diabetes, Prostate Cancer Screening Decision Making Module, Random Child Selection, Social Context, Sugar Sweetened Beverages and Menu Labeling |
| Idaho | Diabetes, Excess Sun Exposure, Random Child Selection |
| Illinois | Childhood Asthma Prevalence, Chronic Obstructive Pulmonary Disease (COPD), Mental Illness & Stigma, Random Child Selection, Social Context |
| Iowa | Adverse Childhood Experience, Mental Illness & Stigma, Pre-Diabetes |
| Kansas | Childhood Asthma Prevalence, Random Child Selection |
| Kentucky | Childhood Asthma Prevalence, Diabetes, Pre-Diabetes, Random Child Selection |
| Maryland | Childhood Asthma Prevalence, Childhood Immunization, Fruits and Vegetables, Random Child Selection |
| Michigan | Childhood Asthma Prevalence, Chronic Obstructive Pulmonary Disease (COPD), Random Child Selection, Social Context |
| Minnesota | Chronic Obstructive Pulmonary Disease (COPD), Diabetes, Excess Sun Exposure, Mental Illness & Stigma, Pre-Diabetes, Sugar Sweetened Beverages and Menu Labeling, Tetanus Diphtheria (Adults) |
| Mississippi | Childhood Asthma Prevalence, Childhood Immunization, Chronic Obstructive Pulmonary Disease (COPD), Diabetes, Pre-Diabetes, Random Child Selection, Sugar Sweetened Beverages and Menu Labeling |
| Missouri | Childhood Asthma Prevalence, Childhood Immunization, Mental Illness & Stigma, Random Child Selection |
| Montana | Childhood Asthma Prevalence, Chronic Obstructive Pulmonary Disease (COPD), General Preparedness, Mental Illness & Stigma, Random Child Selection, Sugar Sweetened Beverages and Menu Labeling, Veteran’s Health |
| Nebraska | Childhood Asthma Prevalence, Random Child Selection |
| Nevada | Childhood Asthma Prevalence, Chronic Obstructive Pulmonary Disease (COPD), Diabetes, Inadequate Sleep, Mental Illness & Stigma, Random Child Selection, Sugar Sweetened Beverages and Menu Labeling |
| New Hampshire | Childhood Asthma Prevalence, Random Child Selection, Sugar Sweetened Beverages and Menu Labeling |
| New Jersey | Childhood Asthma Prevalence, Diabetes, Pre-Diabetes, Random Child Selection |
| New Mexico | Childhood Asthma Prevalence, Diabetes, Mental Illness & Stigma, Pre-Diabetes, Random Child Selection |
| New York | Childhood Asthma Prevalence, Mental Illness & Stigma, Pre-Diabetes, Random Child Selection, Sugar Sweetened Beverages and Menu Labeling |
| Ohio | Childhood Asthma Prevalence, Diabetes, Pre-Diabetes, Random Child Selection |
| Oklahoma | Childhood Asthma Prevalence, Random Child Selection |
| Oregon | Childhood Asthma Prevalence, Chronic Obstructive Pulmonary Disease (COPD), Diabetes, Inadequate Sleep, Mental Illness & Stigma, Random Child Selection |
| Pennsylvania | Adult Asthma History, Childhood Asthma Prevalence, Childhood Immunization, Diabetes, Pre-Diabetes, Random Child Selection |
| Puerto Rico | Childhood Asthma Prevalence, Childhood Immunization, Diabetes, Inadequate Sleep, Mental Illness & Stigma, Pre-Diabetes, Random Child Selection |
| South Carolina | Childhood Immunization, Chronic Obstructive Pulmonary Disease (COPD), Diabetes, Random Child Selection |
| South Dakota | Diabetes, Pre-Diabetes, Random Child Selection, Sugar Sweetened Beverages and Menu Labeling |
| Tennessee | Adult Asthma History, Adverse Childhood Experience, Childhood Asthma Prevalence, Childhood Immunization, Chronic Obstructive Pulmonary Disease (COPD), Diabetes, Fruits and Vegetables, Pre-Diabetes, Random Child Selection, Social Context, Sugar Sweetened Beverages and Menu Labeling, Veteran’s Health |
| Texas | Childhood Asthma Prevalence, Childhood Immunization, Random Child Selection |
| Utah | Childhood Asthma Prevalence, Random Child Selection |
| Vermont | Cancer Survivorship, Diabetes, Pre-Diabetes, Shingles (Zostavax or ZOS), Tetanus Diphtheria (Adults) |
| Virginia | Diabetes, Pre-Diabetes, Shingles (Zostavax or ZOS), Tetanus Diphtheria (Adults) |
| Washington | Childhood Asthma Prevalence, HIV/AIDS, Mental Illness & Stigma, Pre-Diabetes, Random Child Selection |
| West Virginia | Adult Human Papilloma Virus (HPV), Childhood Asthma Prevalence, Diabetes, Pre-Diabetes, Random Child Selection |
| Wisconsin | Adverse Childhood Experience, Cancer Survivorship, Childhood Asthma Prevalence, Diabetes, Pre-Diabetes, Random Child Selection |
| Wyoming | Childhood Asthma Prevalence, Childhood Immunization, Diabetes, Random Child Selection, Reactions to Race |
Page last reviewed: December 15, 2014