nsw population health survey 2013 - questionnaire · 2018. 8. 31. · nsw population health survey...

NSW Population Health Survey 2013 - Questionnaire

Start of demographics 1 age and sex (skip only) ...................................................................................................... 7

Start of self-rated health status and disability (script only)...................................................................................... 9

Start of health services access, use and satisfaction (skip only) ............................................................................... 9

Start of personal health record (skip only) ............................................................................................................ 16

Start of Influenza-like illness (skip only) ................................................................................................................ 17

Start of breastfeeding (script only) ........................................................................................................................ 18

Start of pregnancy and folate (skip only) ............................................................................................................... 23

Start of injury 1 childhood injury and prevention (skip only) ................................................................................. 24

Start of alcohol in pregnancy (skip only)................................................................................................................ 25

Start of asthma prevalence and service use (skip only) ......................................................................................... 25

Start of cardiovascular disease (blood pressure and cholesterol) (script only) ....................................................... 27

Start of cancer screening 2 (prostate and bowel) (skip only) ................................................................................. 29

Start of cancer screening 1 (breast and cervical) (script only) ................................................................................ 30

Start of diabetes 1 prevalence and management (skip only) ................................................................................. 33

Start of injury and prevention Kids Don't Fly (skip only) ........................................................................................ 36

Start of injury and prevention fire and rescue (skip only) ...................................................................................... 40

Start of injury 2 (falls in older people) (skip only) .................................................................................................. 41

Start of alcohol frequency and consumption (skip only) ........................................................................................ 43

Start of height and weight BMI (skip only) ............................................................................................................ 45

Start of nutrition 1 adult dietary guidelines (skip only) .......................................................................................... 46

Start of nutrition 2 child dietary guidelines (skip only) .......................................................................................... 47

Start of food security (skip only) ........................................................................................................................... 57

Start of mental health 1 (adult psychological distress) (skip only) ......................................................................... 57

Start of mental health 2 childhood strengths and difficulties (skip only) ............................................................... 61

Start of social capital (safety, trust, reciprocity & participation) (skip only) ........................................................... 71

Start of immunisation 1 influenza and pneumococcal (skip only) .......................................................................... 74

Start of pertussis evaluation (skip only) ................................................................................................................ 76

Start of HIV test questions .................................................................................................................................... 76

Start of oral health (skip only) ............................................................................................................................... 77

Start of physical activity 1 leisure time (skip only) ................................................................................................. 80

Start of physical activity 3 child activity and inactivity (skip only) .......................................................................... 84

Centre for Epidemiology and Evidence

of 106


Start of smoking 1 prevalence (skip only) .............................................................................................................. 89

Start of cannabis (skip only) .................................................................................................................................. 90

Start of environmental tobacco smoke (skip only) ................................................................................................ 90

Start of tobacco 1 (regulations) (skip only) ............................................................................................................ 91

Start of childcare, school attendance and reading to child (skip only) ................................................................... 92

Start of book reading to child (skip only) ............................................................................................................... 94

Start of concluding demographics (script only) ..................................................................................................... 95


of 106


Question Code

Question Name Notes Age

Groups Question Question Skips

IN1 Introduction (script only)

Existing All Good morning/afternoon/evening, my name is _________ and I am calling from the NSW Ministry of Health. We are conducting an important study on the health and wellbeing of people in NSW and we would like to interview you/someone in your household. The survey is used to help the NSW Ministry of Health plan the provision of healthcare services such as hospitals and clinics in your area and to let us know about current health issues. We would greatly appreciate your /your household's participation in this study and I would like to introduce it to you briefly and explain how it works. 1 Yes 2 HANG UP - SAID NOTHING (CNTRL+END set as No Answer) 3 Language problems - NOT able to Proceed. -> DEM7 4 DISABILITY problem - NOT able to Proceed -> TGB 5 Not resident in New South Wales -> IN10a 6 Holiday house in NSW -> TGB R Refused -> TGB

IN10 Participate Existing All Firstly can I just confirm that you live in NSW? 1 Yes - NSW -> LOTE 2 No X Don't know R Refused

Skip: DEM7 if (IN1=3) Skip: TGB if (IN1=2) Skip: TGB if (IN1=4) Skip: TGB if (IN1=6) Skip: TGB if (IN1=R) Skip: IN10a if (IN1=5)

IN10a State or Territory of residence

Existing All In which state or territory do you live? 1 ACT (An interviewer may contact [you/your household] shortly to conduct the ACT General Health Survey). 2 Victoria 3 Queensland 4 South Australia 5 Western Australia 6 Tasmania 7 Northern Territory 8 Overseas Locality X Don't know R Refused

Skip: LOTE if (IN10=1)


of 106


Question Code



LOTE Survey conducted in LOTE

Existing All [RECORD LANGUAGE SURVEY CONDUCTED IN.] 1 English 2 Arabic 3 Chinese 4 Greek 5 Italian 6 Vietnamese

Skip: TGB if (IN10a=1) Skip: TGB if (IN10a=2) Skip: TGB if (IN10a=3) Skip: TGB if (IN10a=4) Skip: TGB if (IN10a=5) Skip: TGB if (IN10a=6) Skip: TGB if (IN10a=7) Skip: TGB if (IN10a=8) Skip: TGB if (IN10a=X) Skip: TGB if (IN10a=R)

INT1a No. of people living in the household

Existing All Your phone number has been chosen at random from all possible telephone numbers in your area. We would like to make a random selection of a person in your household to interview. If a child under 16 years of age is selected we would interview the parent or main carer of that child. So that we can randomly select one person from your household can you please tell me, how many people, including yourself, live in your household? [IF RESPONDENT REFUSES TO ANSWER USE CTRL-END]

Skip: INT1f if (MOBILE=1)

INT1f No. of children in the household

Existing All And how many of the people living in the household are children under 16 years of age?

Skip: INT1d if (INT1a=1) Skip: INT1d if (MOBILE=1)

INT1d No. of children aged 0-5 in the household

Existing All Can you please tell me, of these, how many are under 6 years of age?

Skip: INT1b if (INT1a=1) Skip: INT1b if (INT1f<1) Skip: INT1b if (MOBILE=1)


of 106


Question Code



POS Age position of speaker

Existing All Now can you tell me if you are the oldest, second oldest,...xth oldest living in your household? 1 Oldest 2 Second oldest 3 Third oldest 4 Fourth oldest 5 Fifth oldest 6 Sixth oldest 7 Seventh oldest 8 Eighth oldest 9 Ninth oldest 10 Tenth oldest 11 Eleventh oldest 12 Twelfth oldest 13 Thirteenth oldest 14 Fourteenth oldest 15 Fifteenth oldest 16 Sixteenth oldest

Skip: INT1c if (INT1a=1) Skip: INT1c if (MOBILE=1)

INT1c Random selection

Existing All We have done the random selection and we would like to interview the xth oldest person in your household. Is that person a child under 16 years of age? 1 Yes, that's me -> IN7a 2 Yes, another person but not available now [MAKE APPOINTMENT-CTRL-END] -> IN7a 3 Yes, I'll get the person -> IN7a 4 Yes, my son/daughter (or other person under 16) 5 Selected respondent does not speak English -> DEM7 6 Selected respondent unable to participate [INTERVIEW PROXY RESPONDENT] -> AIN14 R Refused -> TGB

Skip: INT1g if (MOBILE=1) Skip: TGB if (INT1c=R) Skip: DEM7 if (INT1c=5)

INT1g Ask for main carer (script only)

Existing Child Because we will conduct this survey about a child under 16 years of age we need to speak with the person who knows most about that child's health. Are you the main carer of this child? If NO then ask to speak to the child's main carer and repeat introduction. 1 Continue

Skip: AIN14 if (INT1c=1) Skip: AIN14 if (INT1c=2) Skip: AIN14 if (INT1c=3) Skip: AIN14 if (INT1c=6) Skip: AIN14 if (MOBILE=1)


of 106


Question Code



AIN14 Justification for proxy survey being undertaken

Existing Adult (proxy only)

Would you please tell me why this person is not able to take part in the study? [INT NOTE: Language problems are NOT a proxy survey, return to previous screen and select option 5] 1 Temporary illness (very sick in bed, in hospital) 2 Too confused (has dementia, Alzheimer's) 3 Deaf 4 Had stroke 5 Other [SPECIFY] 6 Unavailable for duration of the study X Don't know R Refused

Skip: IN7 if (MOBILE=1) Skip: IN7 if (INT1c!=6)

IN7 Ask for main carer (script only)

Existing Adult (proxy only)

Because we will conduct this survey about a person who is unable to do the interview themselves, we need to speak with the person who knows most about that person's health. Are you the main carer of this person? If NO then ask to speak to the selected respondent's main carer and repeat introduction. 1 Continue

Skip: IN7a if (MOBILE=1) Skip: IN7a if (INT1c=1) Skip: IN7a if (INT1c=2) Skip: IN7a if (INT1c=3) Skip: IN7a if (INT1c=4)

INT2 Name Existing All Could I have your/proxy's given name? /Could I have the given name of this child? ___________________________________

INT3 Main carer Existing Child We need to interview the parent or main carer of child. Is that you? 1 Yes, that's me -> INT5 2 Yes, but not available now - [MAKE APPOINTMENT - CTRL-END] 3 No, I'll get the person R Refused -> TGB

Skip: INT4 if (CHILD=2) Skip: INT4 if (PROXY=1)

INT4 Re-introduction

Existing Child Good morning/afternoon/evening, my name is _________ and I am calling from the NSW Ministry of Health. We are conducting a State-wide study on the health and wellbeing of people in NSW. The survey will take between 15 and 20 minutes. Would it be convenient to talk to you now? 1 Yes 2 Yes, but not now [MAKE APPOINTMENT - CTRL-END] 3 Refused -> TGB 4 Language difficulty -> DEM7

Skip: INT5 if (CHILD=2) Skip: INT5 if (PROXY=1) Skip: INT5 if (INT3=1) Skip: TGB if (INT3=R)


of 106


Question Code



INT5 Consent Existing All Your help with this survey would be voluntary. All that is involved is answering some questions about your health/your child's health, wellbeing and use of health services. The interview takes around 15 to 20 minutes. You can stop at any time or simply refuse to answer a question should you prefer. During the interview my supervisor may listen in for quality control purposes only. Please be assured that all the answers to questions remain completely confidential, except where you volunteer information that we are required to report by law. [PROMPT IF NECESSARY: All the answers that you give to the questions remain completely confidential. However if you tell us additional information about breaking the law or that suggests a child is being abused or neglected, then we are required to report this to the appropriate authority such as the Department of Community Services.] The information from this survey will be used to help improve health services for people in your area and across the state, so your help is very important to us. 1 Yes 2 Yes, but not available now [MAKE APPOINTMENT - CTRL-END] R Refused

Skip: TGB if (INT4=3) Skip: DEM7 if (INT4=4)

DEMZ Start of demographics 1 age and sex (skip only)

Existing All

DEM2 Child respondent's age (coded)

Existing Child Could you please tell me how old child is today? [NOTE: IF RESPONDENT DOES NOT GIVE CHILDS AGE SURVEY WILL TERMINATE] We summarise all the information we collect according to people's age groups so it is important that we have information about the age of people we are interviewing. We will not be able to conduct the survey unless we know your child's age. 1 Age in months and weeks (0-23 months only) 2 Age in years -> DEM2c X Don't know -> TGB R Refused -> TGB

Skip: TGB if (INT5=R) Skip: DEM2b if (CHILD=2) Skip: DEM2b if (PROXY=1) Skip: TGB if (DEM2=X) Skip: TGB if (DEM2=R)

DEM2b Child respondent's age in months

Existing Child 0-23 months

months [LESS THAN ONE MONTH OLD MUST BE RECORDED AS ZERO]

Skip: DEM2e if (CHILD=2) Skip: DEM2e if (PROXY=1) Skip: DEM2e if (DEM2=2)


of 106


Question Code



DEM2e Child respondent's age in weeks


weeks [WHOLE WEEKS ONLY. ENTER 0, 1, 2 or 3]

Skip: DEM2c if (CHILD=2) Skip: DEM2c if (PROXY=1) Skip: DEM2c if (DEM2=2)

DEM2c Child respondent's age in years

Existing Child 2-15 years

years [INTERVIEWERS: ANSWER IN WHOLE NUMBERS ONLY - DO NOT ROUND UP. FOR EXAMPLE ENTER '5' FOR '5 AND A HALF YEAR OLDS']

Skip: DEM2d if (DEM2!=2) Skip: DEM2d if (CHILD=2) Skip: DEM2d if (PROXY=1)

DEM2d Adult respondent's age in years

Existing Adult Could you please tell me how old you are today? NOTE: IF RESPONDENT DOES NOT GIVE AGE SURVEY WILL TERMINATE We summarise all the information we collect according to people's age groups so it is important that we have information about the age of people we are interviewing. We will not be able to conduct the survey unless we know your age. years 88888 Don't know 99999 Refused [INTERVIEWERS: ANSWER IN WHOLE NUMBERS ONLY - DO NOT ROUND UP.]

Skip: TGB if ((DEM2d=99999)|(DEM2d=88888)&(CHILD=2)

DEM3 Sex Existing Child RECORD CHILD'S SEX [IF UNSURE ASK: Is child a boy or a girl?] 1 Male 2 Female

Skip: DEM4 if (CHILD=2) Skip: DEM4 if (PROXY=1)

DEM4 Child proxy/respondent's sex

Existing Adult RECORD RESPONDENTS SEX [IF UNSURE ASK: Are you male or female?] 1 Male 2 Female


of 106


Question Code



CDM6 Proxy respondent's relationship to child

Existing Child What is your relationship to child? For example are you child's father/mother, stepfather/stepmother or other relation? 1 Mother 2 Father 3 Stepmother 4 Stepfather 5 Grandmother 6 Grandfather 7 Legal guardian/Foster Parent 8 Other X Don't know R Refused

Skip: DEMX if (CHILD=2) Skip: DEMX if (PROXY=1)

DEMX End of demographics 1 age and sex (skip only)

Existing All

HSDZ Start of self-rated health status and disability (script only)

Existing child only in 2013

Child 5 - 15

Now I am going to ask a question about your/child's general health. [KEY "N" TO CONTINUE]

Skip: HSDX if (AGE<5)

HSD4 Self-rated general health


Child 5 - 15

Overall, how would you rate your/child's health during the past 4 weeks? [READ OUT] 1 Excellent 2 Very Good 3 Good 4 Fair 5 Poor 6 Very Poor X Don't know R Refused

HSDX End of self-rated health status and disability (skip only)


Child 5 - 15

HSUZ Start of health services access, use and satisfaction (skip only)


Child Skip: HSUX if (CHILD=2) Skip: HSUX if (PROXY=1)

HSU Introduction to health services used (script only)


Child The next questions are about child's use of health services. [KEY "N" TO CONTINUE]


of 106


Question Code



HSU1a Health service attended in last 12 months


Child In the last 12 months, has child attended any of the following services: [READ OUT] Stayed for at least one night in hospital A hospital emerg. dept. (or casualty) for your own/child's medical care An Early Childhood Centre (<5 years only) A Government run community health centre A Government dental service or dental hospital A general practitioner A specialist Did not attend any of these services Don't know Refused

HSU2aH Type of hospital for most recent overnight stay


Child Can you tell me if the overnight stay was at a public or private hospital? 1 Public Hospital 2 Private Hospital 3 Private Hospital attached to a Public Hospital X Don't know R Refused

Skip: HSU6H if (HSU1a1!=1)

HSU6H Rating of care for most recent overnight hospital stay


Child Overall, what do you think of the care child received at the last hospital he/she attended? Was it... [READ OUT] 1 Excellent -> HSU6ED 2 Very Good -> HSU6ED 3 Good -> HSU6ED 4 Fair 5 Poor X Don't know -> HSU6ED R Refused -> HSU6ED

Skip: HSU7H if (HSU1a1!=1)


of 106


Question Code



HSU7H Reason for rating most recent overnight hospital stay as fair/poor


Child Could you briefly describe why you rated the care child received as fair/poor?

Skip: HSU6ED if (HSU1a1!=1) Skip: HSU6ED if (HSU6H=1) Skip: HSU6ED if (HSU6H=2) Skip: HSU6ED if (HSU6H=3) Skip: HSU6ED if (HSU6H=X) Skip: HSU6ED if (HSU6H=R)

HSU6ED Rating of care for most recent emergency department visit


Child Overall, what do you think of the care child received at the emergency department child last attended? Was it.... [READ OUT] 1 Excellent -> HSU4 2 Very Good -> HSU4 3 Good -> HSU4 4 Fair 5 Poor X Don't know -> HSU4 R Refused -> HSU4

Skip: HSU7ED if (HSU1a2!=1)

HSU7ED Reason for rating most recent emergency department visit as fair/poor



Skip: HSU4 if (HSU1a2!=1) Skip: HSU4 if (HSU6ED=1) Skip: HSU4 if (HSU6ED=2) Skip: HSU4 if (HSU6ED=3) Skip: HSU4 if (HSU6ED=X) Skip: HSU4 if (HSU6ED=R)

HSU4 Currently visiting early childhood centre


Is child seeing a baby health or early childhood health nurse on a regular basis? (PROMPT includes regular visits to early childhood health centre or baby health centre) (PROMPT regular visits means attended last appointment and plan to take child again) 1 Yes -> HSU6B 2 No X Don't know -> HSU6B R Refused -> HSU6B

Skip: HSU5 if (AGE>4)


of 106


Question Code



HSU5 Reason for not currently visiting early childhood centre


Can you tell me the main reason child is not seeing a baby health or early childhood health nurse? 1 Centre at inconvenient location 2 Centre has inconvenient/unsuitable hours 3 Insufficient services 4 Unwelcome atmosphere 5 No need to attend / any more 6 Not useful / Not useful any more 7 Use other services instead 8 Other [SPECIFY] 9 Next scheduled visit not due yet X Don't know R Refused

Skip: HSU6B if (AGE>4) Skip: HSU6B if (HSU4=1) Skip: HSU6B if (HSU4=X) Skip: HSU6B if (HSU4=R)

HSU6B Rating of overall care at early childhood centre


Overall, what do you think of the care child received at the most recent early childhood centre visit? [READ OUT] 1 Excellent -> HSU6CH 2 Very Good -> HSU6CH 3 Good -> HSU6CH 4 Fair 5 Poor X Don't know -> HSU6CH R Refused -> HSU6CH

Skip: HSU7B if (AGE>4) Skip: HSU7B if (HSU1a3!=1)

HSU7B Reason for rating overall care at early childhood centre as fair/poor


Could you briefly describe why you rated the care child received as fair/poor?

Skip: HSU6CH if (AGE>4) Skip: HSU6CH if (HSU6B=1) Skip: HSU6CH if (HSU6B=2) Skip: HSU6CH if (HSU6B=3) Skip: HSU6CH if (HSU6B=X) Skip: HSU6CH if (HSU6B=R) Skip: HSU6CH if (HSU1a3!=1)


of 106


Question Code



HSU6CH Rating of care for most recent community health centre visit


Child Overall, what do you think of the care child received at the community health centre he/she last attended? Was it... [READ OUT] 1 Excellent -> HSU6PD 2 Very Good -> HSU6PD 3 Good -> HSU6PD 4 Fair 5 Poor X Don't know -> HSU6PD R Refused -> HSU6PD

Skip: HSU7CH if (HSU1a4!=1)

HSU7CH Reason for rating most community health centre visit as fair/poor



Skip: HSU6PD if (HSU1a4!=1) Skip: HSU6PD if (HSU6CH=1) Skip: HSU6PD if (HSU6CH=2) Skip: HSU6PD if (HSU6CH=3) Skip: HSU6PD if (HSU6CH=X) Skip: HSU6PD if (HSU6CH=R)

HSU6PD Rating of care for most recent public dental service visit


Child Overall, what do you think of the care child received at the most recent public dental service visit? Was it... [READ OUT] 1 Excellent -> HSU5GP 2 Very Good -> HSU5GP 3 Good -> HSU5GP 4 Fair 5 Poor X Don't know -> HSU5GP R Refused -> HSU5GP

Skip: HSU7PD if (HSU1a5!=1)


of 106


Question Code



HSU7PD Reason for rating most recent public dental service visit as fair/poor



Skip: HSU5GP if (HSU1a5!=1) Skip: HSU5GP if (HSU6PD=1) Skip: HSU5GP if (HSU6PD=2) Skip: HSU5GP if (HSU6PD=3) Skip: HSU5GP if (HSU6PD=X) Skip: HSU5GP if (HSU6PD=R)

HSU5GP Last see a general practitioner


Child When did child last see a general practitioner? 1 Within the last week 2 1 to 2 weeks ago 3 2 weeks to 1 month ago 4 between 1 and 6 months 5 6 to 12 months ago X Don't know R Refused

Skip: HSU6GP if (HSU1a6!=1)

HSU6GP Rating of care for most recent general practitioner visit


Child Overall, what do you think of the care child received at the most recent GP visit? Was it... [READ OUT] 1 Excellent -> HSU6S 2 Very Good -> HSU6S 3 Good -> HSU6S 4 Fair 5 Poor X Don't know -> HSU6S R Refused -> HSU6S

Skip: HSU7GP if (HSU1a6!=1)

HSU7GP Reason for rating most recent general practitioner visit as fair/poor



Skip: HSU6S if (HSU1a6!=1) Skip: HSU6S if (HSU6GP=1) Skip: HSU6S if (HSU6GP=2) Skip: HSU6S if (HSU6GP=3) Skip: HSU6S if (HSU6GP=X) Skip: HSU6S if (HSU6GP=R)


of 106


Question Code



HSU6S Rating of care for most recent specialist visit


Child Overall, what do you think of the care child received at the specialist he/she last attended? Was it... [READ OUT] 1 Excellent -> HSU12n 2 Very Good -> HSU12n 3 Good -> HSU12n 4 Fair 5 Poor X Don't know -> HSU12n R Refused -> HSU12n

Skip: HSU7S if (HSU1a7!=1)

HSU7S Reason for rating most recent specialist visit as fair/poor



Skip: HSU12n if (HSU1a7!=1) Skip: HSU12n if (HSU6S=1) Skip: HSU12n if (HSU6S=2) Skip: HSU12n if (HSU6S=3) Skip: HSU12n if (HSU6S=X) Skip: HSU12n if (HSU6S=R)

HSU12n Home-visit in last 12 months


In the last 12 months, has a child or community nurse visited you/child in your home? 1 Yes 2 No -> HSU14 X Don't know -> HSU14 R Refused -> HSU14

Skip: HSU14 if (AGE>0)

HSU6C Rating of overall care from community nurse in last 12 months


Overall, what do you think of the care child received from this child and community nurse? [READ OUT] 1 Excellent -> HSU14 2 Very Good -> HSU14 3 Good -> HSU14 4 Fair 5 Poor X Don't know -> HSU14 R Refused -> HSU14

Skip: HSU7C if (HSU12n!=1)


of 106


Question Code



HSU7C Reason for rating most recent community nurse as fair/poor


Could you briefly describe why you rated the care you/child received as fair/poor?

Skip: HSU14 if (HSU12n!=1) Skip: HSU14 if (HSU6C=1) Skip: HSU14 if (HSU6C=2) Skip: HSU14 if (HSU6C=3) Skip: HSU14 if (HSU6C=X) Skip: HSU14 if (HSU6C=R)

HSU14 Difficulties in getting health care

Existing All Do you have any difficulties getting health care when you/child need it? 1 Yes 2 No -> HSU16 3 Don't need health care -> HSU16 X Don't know -> HSU16 R Refused -> HSU16

HSU15 Types of difficulties in getting health care

Existing All Please describe the difficulties you have. [PROBE FULLY]

Skip: HSU16 if (HSU14!=1)

HSU16 Comments on health services in local area

Existing All Do you have any comments on the health services in your local area? [PROBE FULLY]

Skip: HSUX if (HSU14=1)

HSUX End of health services access, use and satisfaction (skip only)

Existing

CHSZ Start of personal health record (skip only)

Existing Child Skip: CHSX if (CHILD=2) Skip: CHSX if (PROXY=1)

CHS31 Possess personal health record

Existing Child Do you have a personal health record for child? [NOTE: A personal health record is given to all babies. It contains a record of growth, health check-ups and immunisation It is sometimes referred to as the "blue book"] 1 Yes 2 No -> CHSX X Don't know -> CHSX R Refused -> CHSX


of 106


Question Code



CHS30 Ever used personal health record

Existing Child Have you ever used the personal health record for child? 1 Yes 2 No -> CHSX X Don't know -> CHSX R Refused -> CHSX

Skip: CHSX if (CHS31!=1)

CHS32 Currently use personal health record

Existing Child Do you currently use the personal health record for child? 1 Yes 2 No -> CHSX X Don't know -> CHSX R Refused -> CHSX


CHS33a Current uses of personal health record

Existing Child What do you currently use the personal health record for? [MULTIPLE RESPONSE] Record of immunisation Record of growth (height and weight) Record of visits to baby health or early childhood centre Record of visits to the doctor Information on child health Nothing Other [SPECIFY] Don't know Refused


CHSX End of personal health record (skip only)

Existing Child

ILIZ Start of Influenza-like illness (skip only)

Existing All

ILI1b Influenza like illness in the past 4 weeks

Existing All In the last 4 weeks, did you/child have an illness with any of the following symptoms? [READ OUT] Fever or high temperature Cough Sore throat Fatigue None of the above Don't know Refused


of 106


Question Code



ILI2 See GP for influenza like illness

Existing All Did you/child see a GP for this illness? 1 Yes 2 No X Don't Know R Refused

Skip: ILIX if (ILIM5=1) Skip: ILIX if (ILIM6=1) Skip: ILIX if (ILIM7=1)

ILIX End of influenza-like illness

Existing All

CBFZ Start of breastfeeding (script only)


The next questions are about breastfeeding. [KEY "N" TO CONTINUE]

Skip: CBFX if (DEM2!=1)

CBF1 Child ever breastfed


Has child ever been breastfed? 1 Yes 2 No -> CBF4 X Don't know -> CBF4 R Refused -> CBF4

CBF2 Child currently breastfed


Is child currently being breastfed? 1 Yes 2 No -> CBF13 X Don't know -> CBF13 R Refused -> CBF13

Skip: CBF15 if (CBF1!=1)

CBF15 Breastfed since yesterday


Since this time yesterday, has child been breastfed? [NOTE: Breastfed includes giving expressed breast milk] 1 Yes 2 No X Don't know R Refused

Skip: CBF13 if (CBF1!=1) Skip: CBF13 if (CBF2!=1)

CBF13 Duration of breastfeeding


Including times of weaning, what is the total time child was breastfed? Answer in months and weeks. 2 Answer in months and weeks 3 Less than one week -> CBF4 X Don't know -> CBF4 R Refused -> CBF4

Skip: CBF13b if (CBF1!=1) Skip: CBF13b if (CBF2=1)

CBF13b Duration of breastfeeding months


Including times of weaning, what is the total time child was breastfed? Answer in months and weeks. [ENTER FULL NUMBERS ONLY: IGNORE HALF] months (0-23 months only)

Skip: CBF13a if (CBF1!=1) Skip: CBF13a if (CBF13=X) Skip: CBF13a if (CBF13=R) Skip: CBF13a if (CBF13=3) Skip: CBF13a if (CBF2=1)


of 106


Question Code



CBF13a Duration of breastfeeding weeks


Including times of weaning, what is the total time child was breastfed? Answer in months and weeks. [ENTER FULL NUMBERS ONLY: IGNORE HALF] weeks (up to 3 weeks)

Skip: CBF4 if (CBF1!=1) Skip: CBF4 if (CBF2=1) Skip: CBF4 if (CBF13=X) Skip: CBF4 if (CBF13=R) Skip: CBF4 if (CBF13=3)

CBF4 Child ever regularly given infant or toddler formula.


Has child ever been given infant or toddler formula regularly? [PROMPT IF NECESSARY: regularly means at least once a day] 1 Yes 2 No -> CBF6 X Don't know -> CBF6 R Refused -> CBF6

CBF5 Age first given infant or toddler formula regularly


At what age was child first given infant or toddler formula regularly? Answer in months and weeks. [ENTER FULL NUMBERS ONLY: IGNORE HALF. FOR EXAMPLE ENTER ONE WEEK FOR ONE-AND-A -HALF WEEKS] 2 Answer in months and weeks 3 Less than one week -> CBF6 X Don't know -> CBF6 R Refused -> CBF6

Skip: CBF5b if (CBF4!=1)

CBF5b Age in months first given infant or toddler formula regularly


At what age was child first given infant or toddler formula regularly? Answer in months and weeks. [ENTER FULL NUMBERS ONLY: IGNORE HALF. FOR EXAMPLE ENTER ONE WEEK FOR ONE-AND-A -HALF WEEKS] months (0-23 months only)

Skip: CBF5a if (CBF5=X) Skip: CBF5a if (CBF5=R) Skip: CBF5a if (CBF5=3) Skip: CBF5a if (CBF4!=1)

CBF5a Age in weeks first given infant or toddler formula regularly


At what age was child first given infant or toddler formula regularly? Answer in months and weeks. [ENTER FULL NUMBERS ONLY: IGNORE HALF. FOR EXAMPLE ENTER ONE WEEK FOR ONE-AND-A -HALF WEEKS] weeks (up to 3 weeks)

Skip: CBF6 if (CBF5=X) Skip: CBF6 if (CBF5=R) Skip: CBF6 if (CBF5=3) Skip: CBF6 if (CBF4!=1)

CBF6 Child ever regularly given cow’s milk


Has child ever been given cow’s milk regularly? 1 Yes 2 No -> CBF8 X Don't know -> CBF8 R Refused -> CBF8


of 106


Question Code



CBF7 Age first given cow’s milk


At what age was child first given cow's milk regularly? Answer in months and weeks. [ENTER FULL NUMBERS ONLY: IGNORE HALF. FOR EXAMPLE ENTER ONE WEEK FOR ONE-AND-A -HALF WEEKS] 2 Answer in months and weeks 3 Less than one week -> CBF8 X Don't know -> CBF8 R Refused -> CBF8


CBF7b Age in months first given cow’s milk


At what age was child first given cow's milk regularly? Answer in months and weeks. [ENTER FULL NUMBERS ONLY: IGNORE HALF. FOR EXAMPLE ENTER ONE WEEK FOR ONE-AND-A -HALF WEEKS] months (0-23 months only)


CBF7a Age in weeks first given cow’s milk


At what age was child first given cow's milk regularly? Answer in months and weeks. [ENTER FULL NUMBERS ONLY: IGNORE HALF. FOR EXAMPLE ENTER ONE WEEK FOR ONE-AND-A -HALF WEEKS] weeks (up to 3 weeks)


CBF8 Child ever given other milk substitutes regularly


Has child ever been given any other type of milk substitute on a regular basis? [PROMPT; Apart from breast milk/infant formula/cow’s milk] 1 Yes 2 No -> CBF12 X Don't know -> CBF12 R Refused -> CBF12

CBF9 Types of other milk substitutes


What type of milk substitutes did child have? [MULTIPLE RESPONSE] Soya Bean milk Goat's milk Evaporated milk Other [SPECIFY] Don't know Refused

Skip: CBF10 if (CBF8!=1)


of 106


Question Code



CBF10 Age first given other milk substitutes


At what age was child first given this/any of these milk substitute(s) regularly? Answer in months and weeks. [NOTE: IF USED MORE THAN ONE TYPE OF MILK RECORD EARLIEST AGE THAT ANY MILK SUBSTITUTE WAS GIVEN REGULARLY. ENTER FULL NUMBERS ONLY: IGNORE HALF] 2 Answer in months and weeks 3 Less than one week -> CBF12 X Don't know -> CBF12 R Refused -> CBF12


CBF10b Age in months first given other milk substitutes


At what age was child first given this/any of these milk substitute(s) regularly? Answer in months and weeks. [NOTE: IF USED MORE THAN ONE TYPE OF MILK RECORD EARLIEST AGE THAT ANY MILK SUBSTITUTE WAS GIVEN REGULARLY. ENTER FULL NUMBERS ONLY: IGNORE HALF] months (0-23 months only)


CBF10a Age in weeks first given other milk substitutes


At what age was child first given this/any of these milk substitute(s) regularly? Answer in months and weeks. [NOTE: IF USED MORE THAN ONE TYPE OF MILK RECORD EARLIEST AGE THAT ANY MILK SUBSTITUTE WAS GIVEN REGULARLY. ENTER FULL NUMBERS ONLY: IGNORE HALF] weeks (up to 3 weeks)


CBF12 Age when first given solid food


At what age was child first given solid food regularly? Answer in months and weeks. [ENTER FULL NUMBERS ONLY: IGNORE HALF] 2 Answer in months and weeks 3 Never given solids/not yet started solids -> CNFI9 X Don't know -> CNFI9 R Refused -> CNFI9

CBF12b Age in months when first given solid food


At what age was child first given solid food regularly? Answer in months and weeks. [ENTER FULL NUMBERS ONLY: IGNORE HALF] months (0-23 months only)

Skip: CBF12a if (CBF12=X) Skip: CBF12a if (CBF12=R) Skip: CBF12a if (CBF12=3)

CBF12a Age in weeks when first given solid food


At what age was child first given solid food regularly? Answer in months and weeks. [ENTER FULL NUMBERS ONLY: IGNORE HALF] weeks (up to 3 weeks)

Skip: CNFI9 if (CBF12=X) Skip: CNFI9 if (CBF12=R) Skip: CNFI9 if (CBF12=3)


of 106


Question Code



CNFI9 Age first given fruit juice


At what age was child first given fruit juice regularly? Answer in months and weeks. [ENTER FULL NUMBERS ONLY: IGNORE HALF. FOR EXAMPLE ENTER ONE WEEK FOR ONE-AND-A -HALF WEEKS] 2 Answer in months and weeks 3 Less than one week -> CNFI10 4 Never given fruit juice/not yet started fruit juice -> CNFI10 X Don't know -> CNFI10 R Refused -> CNFI10

CNFI9b Age in months first given fruit juice


At what age was child first given fruit juice regularly? Answer in months and weeks. [ENTER FULL NUMBERS ONLY: IGNORE HALF. FOR EXAMPLE ENTER ONE WEEK FOR ONE-AND-A -HALF WEEKS] months (0-23 months only)

Skip: CNFI9a if (CNFI9=X) Skip: CNFI9a if (CNFI9=R) Skip: CNFI9a if (CNFI9=3) Skip: CNFI9a if (CNFI9=4)

CNFI9a Age in weeks first given fruit juice


At what age was child first given fruit juice regularly? Answer in months and weeks. [ENTER FULL NUMBERS ONLY: IGNORE HALF. FOR EXAMPLE ENTER ONE WEEK FOR ONE-AND-A -HALF WEEKS] weeks (up to 3 weeks)

Skip: CNFI10 if (CNFI9=X) Skip: CNFI10 if (CNFI9=R) Skip: CNFI10 if (CNFI9=3) Skip: CNFI10 if (CNFI9=4)

CNFI10 Age given water


At what age was child first given water regularly? Answer in months and weeks. [ENTER FULL NUMBERS ONLY: IGNORE HALF. FOR EXAMPLE ENTER ONE WEEK FOR ONE-AND-A -HALF WEEKS] 2 Answer in months and weeks 3 Less than one week -> CBF16 4 Never given water/not yet started water -> CBF16 X Don't know -> CBF16 R Refused -> CBF16

CNFI10b Age in months given water


At what age was child first given water regularly? Answer in months and weeks. [ENTER FULL NUMBERS ONLY: IGNORE HALF. FOR EXAMPLE ENTER ONE WEEK FOR ONE-AND-A -HALF WEEKS] months (0-23 months only)

Skip: CNFI10a if (CNFI10=3) Skip: CNFI10a if (CNFI10=R) Skip: CNFI10a if (CNFI10=X) Skip: CNFI10a if (CNFI10=4)


of 106


Question Code



CNFI10a Age in weeks given water


At what age was child first given water regularly? Answer in months and weeks. [ENTER FULL NUMBERS ONLY: IGNORE HALF. FOR EXAMPLE ENTER ONE WEEK FOR ONE-AND-A -HALF WEEKS] weeks (up to 3 weeks)

Skip: CBF16 if (CNFI10=3) Skip: CBF16 if (CNFI10=R) Skip: CBF16 if (CNFI10=X) Skip: CBF16 if (CNFI10=4)

CBF16 Receive any of the following since yesterday


Since this time yesterday, did child receive any of the following? [READ OUT] [MULTIPLE RESPONSE] Vitamins, mineral supplements, medicine Plain water Sweetened or flavoured water Fruit juice Tea or infusion Infant formula Tinned, powdered or fresh milk Solid or semi-solid food Other [SPECIFY] Don't know Refused None of these

Skip: CBFX if (DEM2b>7)

CBFX End of breastfeeding (skip only)


CNFPZ Start of pregnancy and folate (skip only)

Existing All

PREG Pregnancy Existing Women between 16 and 40

To your knowledge are you pregnant? 1 Yes 2 No X Don't know R Refused

Skip: CNFINT if (CHILD=2)&(RSEX=1) Skip: CNFINT if (CHILD=1) Skip: CNFINT if (PROXY=1)&(RSEX=1) Skip: CNFINT if (CHILD=2)&(AGE>40) Skip: CNFINT if (PROXY=1)&(AGE>40)

CNFINT Introduction to pregnancy and folate (script only)

Existing Mothers of babies <12 months

The next few questions refer to your pregnancy with child. [KEY "N" TO CONTINUE]

Skip: CNF5b if (AGE>0) Skip: CNF5b if (CDM6!=1)


of 106


Question Code



CNF5b Take tablets or capsules containing 0.5mg folate in month prior to pregnancy

Existing Mothers of babies <12 months and/or PREG=1

Did you take capsules or tablets containing at least 0.5mg of folate daily in the month immediately before you became pregnant? [READ OUT 1-4] 1 Yes daily 2 Yes regularly but not daily 3 Yes sometimes 4 No 5 Not applicable not the birth mother -> CNFPX X Don't know R Refused

Skip: CNF6b if (PREG=2) Skip: CNF6b if (PREG=X) Skip: CNF6b if (PREG=R) Skip: CNF6b if (RSEX=1) Skip: CNF6b if (AGE>40)&(CHILD=2) Skip: CNF6b if (AGE>40)&(PROXY=1) Skip: CNF6b if (CHILD=1)&(AGE!=0) Skip: CNF6b if (CHILD=1)&(CDM6!=1)

CNF6b Take tablets or capsules containing 0.5mg folate in first 3 months of pregnancy

Existing Mothers of babies <12 months and/or PREG=1

Did you take capsules or tablets containing at least 0.5mg of folate daily in the first three months of this pregnancy? [READ OUT 1-4] 1 Yes daily 2 Yes regularly but not daily 3 Yes sometimes 4 No 5 Not applicable not the birth mother X Don't know R Refused

Skip: CNFPX if (PREG=2) Skip: CNFPX if (PREG=X) Skip: CNFPX if (PREG=R) Skip: CNFPX if (RSEX=1) Skip: CNFPX if (AGE>40)&(CHILD=2) Skip: CNFPX if (AGE>40)&(PROXY=1) Skip: CNFPX if (CHILD=1)&(AGE!=0) Skip: CNFPX if (CHILD=1)&(CDM6!=1) Skip: CNFPX if (CNF5b=5)

CNFPX End of pregnancy and folate (skip only)

Existing

CSDZ Start of injury 1 childhood injury and prevention (skip only)


Skip: CSDX if (AGE>0)


of 106


Question Code



CSD3 Sleeping position from birth


What position did you put child to sleep in from birth? [READ OUT] 1 On his/her back 2 On his/her side 3 On his/her tummy 4 Any other position [SPECIFY] X Don't know R Refused

CSDX End of injury 1 childhood injury and prevention (skip only)

Existing

ALCPZ Start of alcohol in pregnancy (skip only)

Existing Child 0-11 months (mothers only)

Skip: ALCPX if (AGE>0) Skip: ALCPX if (RSEX!=2) Skip: ALCPX if (CDM6!=1)

ALCP2 Alcohol during pregnancy


When you were pregnant with child, did you ever drink alcohol? 1 Yes 2 No -> ALCPX X Don't know R Refused

ALCP3 Alcohol quitting status during pregnancy


When you were pregnant with child, did you... [READ OUT OPTIONS 1-3] 1 Reduce the amount of alcohol you drank 2 Try to give up drinking alcohol but were unsuccessful 3 Successfully gave up drinking alcohol 4 None of the above X Don't know R Refused

Skip: ALCPX if (ALCP2=2)

ALCPX End of alcohol in pregnancy (skip only)


ASTZ Start of asthma prevalence and service use (skip only)

Existing 2+ years Skip: ASTX if (AGE<2)


of 106


Question Code



AST Introduction to asthma prevalence and service use (script only)

Existing 2+ years The next few questions are about asthma. [KEY "N" TO CONTINUE]

AST1 Ever told by doctor have asthma

Existing 2+ years Have you ever been told by a doctor or at a hospital that you have/child has asthma? 1 Yes 2 No -> ASTE3 X Don't know -> ASTE3 R Refused -> ASTE3

Skip: AST2 if (AST1!=1)

AST2 Asthma symptoms or treatment in last 12 months

Existing 2+ years Have you/Has child had symptoms of asthma or taken treatment for asthma in the last 12 months? 1 Yes - symptoms 2 Yes - treatment 3 Yes - both 4 No -> ASTE3 X Don't know -> ASTE3 R Refused -> ASTE3

Skip: ASTE if (AST1!=1) Skip: ASTE if (AST2=4) Skip: ASTE if (AST2=X) Skip: ASTE if (AST2=R)

ASTE Doctor visits for asthma

Existing 2+ years Have you/Has child visited your/his/her GP for your/his/her asthma in the last 12 months? 1 Yes 2 No -> CA8b X Don't know -> CA8b R Refused -> CA8b

Skip: ASTE1a if (AST1!=1) Skip: ASTE1a if (AST2=4) Skip: ASTE1a if (AST2=X) Skip: ASTE1a if (AST2=R)

ASTE1a Number of urgent doctor visits for asthma

Existing 2+ years How many of these visits were urgent visits, for example, because of worsening asthma or asthma attacks? No of visits 88888 Don't know 99999 Refused

Skip: ASTE1b if (AST1!=1) Skip: ASTE1b if (AST2=4) Skip: ASTE1b if (AST2=X) Skip: ASTE1b if (AST2=R) Skip: ASTE1b if (ASTE!=1)

ASTE1b Number of script only visits for asthma

Existing 2+ years How many of these visits were prescription only visits? No of visits 88888 Don't know 99999 Refused

Skip: ASTE1c if (AST1!=1) Skip: ASTE1c if (AST2=4) Skip: ASTE1c if (AST2=X) Skip: ASTE1c if (AST2=R) Skip: ASTE1c if (ASTE!=1)


of 106


Question Code



ASTE1c Number of planned review visits for asthma

Existing 2+ years How many of these visits were planned reviews, for example, review of symptoms or medications? No of visits 88888 Don't know 99999 Refused

Skip: CA8b if (AST1!=1) Skip: CA8b if (AST2=4) Skip: CA8b if (AST2=X) Skip: CA8b if (AST2=R) Skip: CA8b if (ASTE!=1)

CA8b Written asthma action plan

Existing 2+ years Do you/Does child have an asthma action plan, written instructions of what to do if your/his/her asthma is worse or out of control? 1 Yes 2 No X Don't know R Refused

Skip: ASTE2 if (AST1!=1) Skip: ASTE2 if (AST2=4) Skip: ASTE2 if (AST2=X) Skip: ASTE2 if (AST2=R)

ASTE2 Frequency of asthma symptoms

Existing 2+ years In the last 4 weeks, how often have you/has child had asthma symptoms? 1 Every day 2 3 or more days a week 3 1-2 days a week 4 Less than once a week 5 Not at all X Don't know R Refused

Skip: ASTE3 if (AST1!=1) Skip: ASTE3 if (AST2=4) Skip: ASTE3 if (AST2=X) Skip: ASTE3 if (AST2=R)

ASTE3 Asthma waking at night

Existing 2+ years In the last 4 weeks, how many times have you/has child woken up because of your/their asthma? 1 Every day 2 3 or more days a week 3 1-2 days a week 4 Less than once a week 5 Not at all X Don't know R Refused

ASTX End of asthma prevalence and service use (skip only)

Existing 2+ years

CVDZ Start of cardiovascular disease (blood pressure and cholesterol) (script only)

Existing Adult Now I would like to ask you about blood pressure and cholesterol. [KEY 'N' TO CONTINUE]

Skip: CVDX if (AGE<16)


of 106


Question Code



CVD1 When blood pressure last measured

Existing Adult When did you last have your blood pressure measured? [PROMPT IF NECESSARY] [THIS DOES NOT INCLUDE BLOOD PRESSURE TAKEN AT HOME, GYM ETC. - IT MUST BE CARRIED OUT BY A MEDICAL PRACTITIONER/NURSE] 1 0-3 months 2 4-6 months 3 7-12 months 4 13 months to 2 years ago 5 More than 2 years ago 6 Never measured -> CVD4 X Don't Know R Refused

CVD2 Ever told had high blood pressure

Existing Adult Have you ever been told by a doctor or at a hospital that you have high blood pressure sometimes called hypertension? 1 Yes 2 Yes, but only during pregnancy 3 Yes, but only temporarily 4 No X Don't Know R Refused

Skip: CVD4 if (CVD1=6)

CVD4 When cholesterol last measured

Existing Adult When did you last have your cholesterol measured? [PROMPT IF NECESSARY] 1 0-6 months 2 7-12 months 3 13 months to 2 years ago 4 More than 2 years ago 5 Never measured -> CVDX X Don't know R Refused

CVD5 Ever told had high cholesterol

Existing Adult Have you ever been told by a doctor or at a hospital that you have high cholesterol? 1 Yes 2 No 3 Borderline X Don't Know R Refused

Skip: CVDX if (CVD4=5)


of 106


Question Code



CVDX End of cardiovascular disease (blood pressure and cholesterol) (script only)

Existing Adult

CRCZ Start of cancer screening 2 (prostate and bowel) (skip only)

Returning from 2011

Adults 50+ years

Skip: CRCX if (AGE<50)

CRC10 Bowel cancer screening in last 12 months

Returning from 2011

Adults 50+ years

Bowel cancer is a common cancer which, if found, can be treated at an early stage. Bowel cancer may be detected by using several different types of investigations. In the past 2 years have you ever had: [READ OUT] [IF NEEDED: A colonoscopy is a test which involves a doctor passing a long tube through your back passage to examine the inside of your bowel.] A faecal occult blood test A Colonoscopy A Sigmoidoscopy A CT Colonography A Barium Enema None of these Don't know Refused

CRC11a When last faeces examination

Returning from 2011

Adults 50+ years

When did you have your last faecal occult blood test? [READ OUT] 1 Within the last 12 months 2 13 months to 2 years ago X Don't Know R Refused

Skip: CRC4 if (CRC2S1!=1)


of 106


Question Code



CRC4 Reason for bowel cancer investigation

Returning from 2011

Adults 50+ years

Can you tell me all the reasons why you had [this/these] investigations for bowel cancer? [MULTIPLE RESPONSE] One or more relatives had bowel cancer Regular check-up (seeing doctor) Due for screening test for bowel cancer Doctor recommended it Publicity about bowel cancer and screening Urged by a friend/relative to go Blood in the toilet bowl/stool/on toilet paper Other bowel problem such as pain, polyps or inflammatory bowel disease I have had bowel cancer in the past Inclusion in National Bowel Survey Screening program Other (Specify) Don't know Refused

Skip: CRCX if (CRC2S1!=1)&(CRC2S2!=1)&(CRC2S3!=1)&(CRC2S4!=1)&(CRC2S5!=1)

CRCX End of cancer screening 2 (prostate and bowel) (skip only)

Returning from 2011

Adults 50+ years

CASZ Start of cancer screening 1 (breast and cervical) (script only)

Returning from 2011

Women 20-79

I would now like to ask you some questions about women's health matters. [KEY 'N' TO CONTINUE]

Skip: CASX if (RSEX=1) Skip: CAS1 if (AGE<20) Skip: CAS1 if (AGE>79)

CAS1 Ever had mammogram

Returning from 2011

Women 40-79

A mammogram is an X-ray taken of the breasts by a machine that presses against the breast while the picture is taken. It is a means of detecting breast cancer in the early stages. Have you ever had a mammogram? 1 Yes 2 No -> CASW2 X Don't know -> CASW2 R Refused -> CASW2

Skip: CAS15 if (AGE<40) Skip: CAS15 if (AGE>79)


of 106


Question Code



CAS2 When was last mammogram

Returning from 2011

Women 40-79

When did you last have a mammogram? [PROMPT IF NECESSARY] 1 Less than 1 year ago 2 1 year to less than 2 years ago 3 2 years to less than 3 years ago 4 3 years to less than 4 years ago 5 4 years to less than 5 years ago 6 5 or more years ago X Don't Know R Refused

Skip: CAS3 if (CAS1!=1)

CAS3 Reason for last mammogram

Returning from 2011

Women 40-79

Can you tell me all the reasons why you had your last mammogram? [PROMPT IF NECESSARY - MULTIPLE RESPONSE] Breast problem (lump, discharge, pain) Family history Had breast cancer in the past Regular check up Due for screening mammogram Doctor recommended it An invite from Breast Screen or Breast Screening and Assessment Service Publicity about breast cancer and screening Urged by a friend/relative to go Other [SPECIFY] Don't Know Refused

Skip: CASW if (CAS1!=1)

CASW Location of last mammogram

Returning from 2011

Women 40-79

Where did you have your last mammogram? 1 BreastScreen or Breast Screening and Assessment Service 2 Private provider X Don't know R Refused

Skip: CASW2 if (CAS1!=1)


of 106


Question Code



CASW2 Why have not had a mammogram

Returning from 2011

Women 40-79

Why have you not had a mammogram before? Don't have time I've heard they hurt a lot Not worried/concerned about breast cancer Haven't had the need (no lump/no pain or trouble) Doctors haven't asked/advised me to go I don't have any family history of breast cancer I've heard bad things about them (NFI) Not comfortable doing it I am not old enough for breast screening A mammogram could be wrong so I don't have them I self-examine my breasts Too worried what the results would be Too far to travel/not conveniently located I don't have them because they have radiation/too much radiation Other [SPECIFY] Don't know Refused

Skip: CAS15 if (CAS1=1)

CAS15 Ever had pap test

Returning from 2011

Women 20-69

A Pap test is a routine test carried out by a doctor. It is recommended for all women for early detection of cancer of the cervix. Have you ever had a Pap test? 1 Yes 2 No -> CASW4 X Don't know -> CASW4 R Refused -> CASW4

Skip: CASX if (RSEX=1) Skip: CASX if (AGE<20) Skip: CASX if (AGE>69)

CAS11 When had last pap test

Returning from 2011

Women 20-69

When did you last have a Pap test? [PROMPT IF NECESSARY] 1 Less than 1 year ago 2 1 year to less than 2 years ago 3 2 years to less than 3 years ago 4 3 years to less than 4 years ago 5 4 years to less than 5 years ago 6 5 or more years ago X Don't know R Refused



of 106


Question Code



CASW3 Reasons for last pap test

Returning from 2011

Women 20-69

Can you tell me all the reasons why you had your last pap test? Doctor/GP/Health Professional Friends/family/partner Advertising (TV, newspapers, magazines, radio, online) Social Media (facebook, twitter, blogs) Brochures/pamphlets Have one regularly/part of routine health behaviour Family history of cervical cancer NSW Pap test register (reminder letter) Other [SPECIFY] Don't know Refused


CASW4 Reasons for never having a pap test

Returning from 2011

Women 20-69

Why have you not had a Pap test before? Frightened/fear of pain discomfort One partner Lesbian Never had symptoms Too old Hysterectomy Haven't had sex yet Embarrassing Lack of time Not at risk Have a male GP/Dr Had HPV vaccine Too expensive Doctor hasn't asked/advised me to have one Other [SPECIFY] Don't know Refused

Skip: CASX if (CAS15=1)

CASX End of cancer screening 1 (breast and cervical) (skip only)

Returning from 2011

Women 20-79

DBTZ Start of diabetes 1 prevalence and management (skip only)

Existing 9+ years Skip: DBTX if (AGE<9)

DBT Next questions are about diabetes (script only)

Existing 9+ years The next few questions are about diabetes and high blood glucose. Diabetes is a disease where there is too much glucose in the blood. [KEY "N" TO CONTINUE]


of 106


Question Code



DBT1 Ever told by doctor had diabetes

Existing 9+ years Have you/Has child ever been told by a doctor or at a hospital that you have/he/she has diabetes? 1 Yes 2 No 3 Only during pregnancy -> DBT4 X Don't know R Refused

DBT2 Ever told by doctor have high blood glucose

Existing 9+ years Have you/Has child ever been told by a doctor or at a hospital that you have/he/she has high glucose levels in your/his/her blood or urine? 1 Yes 2 No -> DBT6 3 Borderline 4 Only during pregnancy -> DBTX X Don't know -> DBTX R Refused -> DBTX

Skip: DBT3 if (DBT1=1)&(RSEX=2) Skip: DBT3 if (DBT1=1)&(RSEX=1) Skip: DBT3 if (DBT1=3)

DBT3 Pregnant when first had diabetes/high blood glucose

Existing Adult females

Were you pregnant when you were first told you had diabetes/high blood glucose? 1 Yes 2 No -> DBT19 X Don't know -> DBT19 R Refused -> DBT19

Skip: DBT4 if (DBT1=1)&(CHILD=2)&(RSEX=1)) Skip: DBT4 if (DBT1=3) Skip: DBT4 if (DBT2=2) Skip: DBT4 if (DBT2=1)&(CHILD=2)&(RSEX=1)) Skip: DBT4 if (DBT2=4) Skip: DBT4 if (DBT2=X) Skip: DBT4 if (DBT2=R) Skip: DBT4 if (DBT2=3)&(RSEX=1) Skip: DBT4 if (DBT2=3)&(CHILD=1) Skip: DBT4 if (CHILD=1) Skip: DBT4 if (RSEX=1)


of 106


Question Code



DBT4 Apart from pregnancy, had diabetes/high blood glucose

Existing Adult females

Have you ever had diabetes/high blood glucose apart from when you were pregnant? 1 Yes 2 No -> DBTX X Don't know -> DBTX R Refused -> DBTX

Skip: DBT19 if (DEM2=1)|(DEM2=2)&(DEM2B<12)) Skip: DBT19 if (DBT1=1)&(CHILD=2)&(RSEX=1)) Skip: DBT19 if (DBT2=2) Skip: DBT19 if (DBT2=1)&(CHILD=2)&(RSEX=1)) Skip: DBT19 if (DBT2=4) Skip: DBT19 if (DBT2=X) Skip: DBT19 if (DBT2=R) Skip: DBT19 if (DBT2=3)&(RSEX=1) Skip: DBT19 if (DBT3!=1) Skip: DBT19 if (RSEX=1) Skip: DBT19 if (DBT4!=1)

DBT19 Type of diabetes

Existing 9+ years What type of diabetes were you told you/child had? 1 Type 1 2 Type 2 3 Gestational 4 Other [SPECIFY] X Don't know R Refused

Skip: DBT6 if (DBT1!=1)&(DBT1!=3) Skip: DBT6 if (DBT1=3) Skip: DBT6 if (DBT2=2) Skip: DBT6 if (DBT2=1)&(CHILD=2)&(RSEX=1)) Skip: DBT6 if (DBT2=4) Skip: DBT6 if (DBT2=X) Skip: DBT6 if (DBT2=R) Skip: DBT6 if (DBT2=3)&(RSEX=1) Skip: DBT6 if (DBT4=2) Skip: DBT6 if (DBT4!=1)


of 106


Question Code



DBT6 Current management of diabetes/high blood glucose

Existing 9+ years What are you/is child doing now to manage your/their diabetes/high blood glucose? [MULTIPLE RESPONSE] Having insulin injections On tablets for diabetes or high blood glucose Following a special diet eg reducing sugar and or fat in the diet Losing weight Exercising most days Doing anything else to manage your diabetes/high blood glucose Other [SPECIFY] Not doing anything to control diabetes Don't know Refused

Skip: DBTX if (DBT1=3) Skip: DBTX if (DBT1=2)&(DBT2=2) Skip: DBTX if (DBT2=4) Skip: DBTX if (DBT2=X) Skip: DBTX if (DBT2=R) Skip: DBTX if (DBT4=2) Skip: DBTX if (DBT4!=1)

DBTX End of diabetes 1 prevalence and management (skip only)

Existing 9+ years

INJKDFZ Start of injury and prevention Kids Don't Fly (skip only)

Field tested in early 2013 introduced in quarter 3

Adult Skip: INJKDFX if (CHILD=1)

KDFINT Introduction to Kids Don't Fly


Adult My next few questions are about safety around the home [KEY N TO CONTINUE]


of 106


Question Code



KDF1 Prevent children falling from windows or off balconies


Adult In general, what do you think can be done to prevent children falling from windows or off balconies? [INT NOTE: Safe balconies or balustrades are 1m high, no wider than 12.5cm and have no horizontal bars] Fitting guards/safety nets or screens/locks/latches on windows Opening windows from the top Keeping beds and furniture away from windows (so children can't climb) Teaching children to play away from windows Ensure balconies & balustrades safe (1m high minimum, vertical bars,12.5cm gap max) Keeping the edge of balconies free from climbable objects (e.g. furniture) Supervising children at all times Other [SPECIFY] Don't know Refused

KDF2 Housing type Field tested in early 2013 introduced in quarter 3

Adult Now I would like to ask you some questions about the housing you live in What type of housing do you live in? [READ OUT] 1 Single storey house/townhouse/terrace 2 Ground floor of units/flats 3 Mixed level house / pole house / Elevated house 4 Double storey house/townhouse/terrace 5 Second level of units/flats 6 Above the second level of multiple storey units / flats 7 Other [SPECIFY] X Don't know R Refused

KDF3 Window safety


Adult Do all windows in your home have guards, latches or locks fitted that stop them opening more than 12.5cm (that is about 5 inches)? 1 Yes 2 No 3 Some windows (not all) X Don't know R Refused


of 106


Question Code



KDF4 Vertical railings screen


Adult Do you have one or more balconies in your home? 1 Yes 2 No -> KDF6 X Don't Know -> KDF6 R Refused -> KDF6

KDF4a Vertical railings


Adult Are the railings on your balcony.... [READ OUT] 1 Horizontal bars -> KDF5a 2 Vertical rails (not including top rail) 3 Solid, without gaps -> KDF5a 4 Lattice or decorative -> KDF5a X Don't know -> KDF5a R Refused -> KDF5a

Skip: KDF5 if (KDF4!=1)

KDF5 Vertical railing safety


Adult Do the vertical railings on your balcony have gaps of no more than 12.5cms (that's about 5 inches or the width of CD) between them? 1 Yes 2 No X Don't know R Refused

Skip: KDF5a if (KDF4!=1) Skip: KDF5a if (KDF4a!=2)

KDF5a Vertical railing height


Adult Is the top railing on your balcony at least 1 metre high? 1 Yes 2 No X Don't know R Refused

Skip: KDF6 if (KDF4!=1)

KDF6 Housing ownership


Adult In the housing you live in, are you [READ OUT] 1 The home owner (or paying mortgage) 2 Renting or leasing the home 3 Paying rent to the government for public housing 4 Living there rent or board free 5 Other [SPECIFY] X Don't know R Refused


of 106


Question Code



KDF7 Frequency of young children in home


Adult How often do you have young children aged under 10 years old in your home? Do you have young children under 10 years..... [READ OUT] 1 Living in your home 2 In your home once a week or more 3 In your home less than once a week 4 Never in your home 5 Other [SPECIFY] X Don't know R Refused

KDF8 Campaign awareness Kids Don't Fly


Adult In the last 12 months, did you see, hear or receive any information about preventing children falling from windows and balconies? 1 Yes, mentions 'Kids Don't Fly' campaign by name 2 Yes, describes some details of the campaign (see checklist below) 3 No 4 Media report of accident 5 Other [SPECIFY] X Don't know R Refused to answer CHECKLIST - always supervise children near windows or on balconies - teach children to play away from windows - lock access to balconies when not in use - keep furniture & climbable objects away from windows & balcony edges - have guards/latches/locks limiting window opening to 12.5cm or less (above ground floor) - have top opening windows - know flyscreens don't stop a child from falling through windows - ensure that balustrades are in good condition & safe - balustrade have gaps no wider than 12.5cm & are at least 1m in height - balustrades should not have horizontal/climbable bars.

INJKDFX End of injury and prevention Kids Don't Fly (skip only)


Adult


of 106


Question Code



INJBZ Start of injury and prevention fire and rescue (skip only)

Returning from 2010

All

INJNT Introduction to fire and rescue

Returning from 2010

All Now I have some questions about home fire prevention. [KEY N TO CONTINUE]

INJ40 Smoke alarms installed

Returning from 2010

All Do you have smoke alarms installed in your home? [IF YES ASK: Battery operated, hard wired or both?] 1 Yes - Battery operated smoke alarms 2 Yes - Hard wired smoke alarms -> INJ43 3 Yes - Both battery operated and hard wired 4 No -> INJ46 X Don't know -> INJ46 R Refused -> INJ46

INJ41 Last tested battery operated smoke alarm

Returning from 2010

All When did you last test the battery operated smoke alarm(s)? 1 Within the last month 2 More than a month but less than six months ago 3 Six months to a year ago 4 More than a year ago 5 Never tested 6 No battery currently in alarm X Don't know R Refused

Skip: INJ43 if (INJ40=2) Skip: INJ43 if (INJ40=4) Skip: INJ43 if (INJ40=X) Skip: INJ43 if (INJ40=R)

INJ43 Last test the hard wired smoke alarms

Returning from 2010

All When did you last test the hard wired smoke alarm(s)? 1 Within the last month 2 More than a month but less than six months ago 3 Six months to a year ago 4 More than a year ago 5 Never tested X Don't know R Refused

Skip: INJ46 if (INJ40=1) Skip: INJ46 if (INJ40=4) Skip: INJ46 if (INJ40=X) Skip: INJ46 if (INJ40=R)

INJ46 Home escape plans

Returning from 2010

All Does your household have... [READ OUT] 1 A written home escape plan 2 A home escape plan that is not written down 3 No home escape plan -> INJ19 X Don't know -> INJ19 R Refused -> INJ19


of 106


Question Code



INJ47 Practice home escape plans

Returning from 2008

All When did your household last practice your home escape plan? 1 Within the last month 2 More than a month but less than six months ago 3 Six months to a year ago 4 More than a year ago 5 Never practiced the plan X Don't know R Refused

Skip: INJ19 if (INJ46=3) Skip: INJ19 if (INJ46=X) Skip: INJ19 if (INJ46=R)

INJ19 Fire education program participation

Returning from 2010

All Has child participated in the fire education programme in schools? 1 Yes 2 No -> INJBX X Don't know -> INJBX R Refused -> INJBX

Skip: INJ20 if (AGE>12) Skip: INJ20 if (AGE<5)

INJ20 Components of fire program

Returning from 2010

All Did child tell you about any of the following? [READ OUT] Get down low & go go go Home Fire Escape Plan Stop, Drop, Cover and Roll Install smoke alarms None of the above Refused

Skip: INJ21 if (AGE>12) Skip: INJ21 if (AGE<5) Skip: INJ21 if (INJ19!=1)

INJ21 Action on education program.

Returning from 2010

All Did you take action on any of these things? 1 Yes 2 No X Don't know R Refused

Skip: INJBX if (AGE>12) Skip: INJBX if (AGE<5) Skip: INJBX if (INJ19!=1) Skip: INJBX if (INJ20=5) Skip: INJBX if (INJ20=6)

INJBX End of injury and prevention fire and rescue (skip only)

Returning from 2010

All

INJZ Start of injury 2 (falls in older people) (skip only)

Returning from 2011

Adults 60+ years

The next section is about falls. [KEY N TO CONTINUE]

Skip: INJX if (AGE<60)


of 106


Question Code



INJ90 Any action to prevent falls

Returning from 2011

Adults 60+ years

Have you made any changes to your home or lifestyle to prevent you from falling? 1 Yes 2 No -> INJ92 X Don't know -> INJ92 R Refused -> INJ92

INJ91 Type of action to prevent falls

Returning from 2011

Adults 60+ years

What did you do? Got more exercise Had eyes checked Changed my footwear Changed my medications Installed hand rails Replaced steps with ramps Removed clutter from my house Removed mats/rugs Removed loose cords/appliance leads Got a personal alarm Improved the lighting Repaired unsafe/unsteady furniture Other [SPECIFY] Don't Know Refused

Skip: INJ92 if (INJ90!=1)

INJ92 Fear of falling Returning from 2011

Adults 60+ years

Are you afraid of falling? 1 Yes 2 No X Don't know R Refused

INJ22 Fall in last 12 months

Returning from 2011

Adults 60+ years

In the last 12 months have you had a fall? 1 Yes 2 No -> INJX X Don't know -> INJX R Refused -> INJX

INJ23 Number of accidental falls in last 12 months

Returning from 2011

Adults 60+ years

How many times did you fall in the last 12 months? 1 Once 2 Twice 3 Three times or more X Don't know R Refused



of 106


Question Code



INJ24 Fall which required medical attention in last 12 months

Returning from 2011

Adults 60+ years

In the last 12 months have you had a fall which required medical treatment for injuries? 1 Yes 2 No -> INJ93 X Don't know -> INJ93 R Refused -> INJ93


INJ25 Admitted to hospital for most recent accidental fall

Returning from 2011

Adults 60+ years

Were you ADMITTED to hospital as a result of any of your falls in the last 12 months? 1 Yes 2 No X Don't know R Refused

Skip: INJ93 if (INJ22!=1) Skip: INJ93 if (INJ24!=1)

INJ93 Falls in last 4 weeks

Returning from 2011

Adults 60+ years

In the last 4 weeks have you had a fall? 1 Yes 2 No X Don't know R Refused

Skip: INJX if (INJ22!=1)

INJX End of injury 2 (falls in older people) (skip only)

Returning from 2011

Adults 60+ years

ALCZ Start of alcohol frequency and consumption (skip only)

Existing Adult Skip: ALCX if (CHILD=1)

ALC Alcohol introduction

Existing Adult Now I would like to ask you some questions about alcohol. [KEY "N" TO CONTINUE]

ALC1 How often do you have an alcoholic drink

Existing Adult How often do you usually drink alcohol? [PROMPT IF NECESSARY] 1 Record in days per week 2 Less than once per week -> ALC2 3 I don't drink alcohol -> ALCX X Don't know -> ALCX R Refused -> ALCX

ALC1a How often in days per week have an alcoholic drink

Existing Adult [ENTER NUMBER OF DAYS AND PRESS ENTER] days per week

Skip: ALC2 if (ALC1=2) Skip: ALC2 if (ALC1=3) Skip: ALC2 if (ALC1=X) Skip: ALC2 if (ALC1=R)


of 106


Question Code



ALC2 Usual number of standard drinks per day

Existing Adult Alcoholic drinks are measured in terms of a "standard drink". A standard drink is equal to 1 middy of full-strength beer, 1 schooner of light beer, 1 small glass of wine or 1 pub-sized nip of spirits. On a day when you drink alcohol, how many standard drinks do you usually have? [PROMPT IF NECESSARY] 1 Record number of drinks X Don't know -> ALC3 R Refused -> ALC3

Skip: ALC2a if (ALC1=3) Skip: ALC2a if (ALC1=X) Skip: ALC2a if (ALC1=R)

ALC2a How many standard drinks per day

Existing Adult [ENTER NUMBER OF DRINKS AND PRESS ENTER] number of drinks

Skip: ALC3 if (ALC1=3) Skip: ALC3 if (ALC1=X) Skip: ALC3 if (ALC1=R) Skip: ALC3 if (ALC2=X) Skip: ALC3 if (ALC2=R)

ALC3 More than 4 male/2 female drinks in a day in past 4 weeks

Existing Adult In the past four weeks have you had more than 4 (if male) or 2 (if female) drinks in a day? 1 Yes 2 No -> ALCX X Don't know -> ALCX R Refused -> ALCX

Skip: ALC4 if (ALC1=3) Skip: ALC4 if (ALC1=X) Skip: ALC4 if (ALC1=R)

ALC4 More than 11 male/7 female drinks in a day in past 4 weeks

Existing Adult In the past 4 weeks how often have you had 11 or more (if male) or 7 or more (if female) drinks in a day? 1 Record number of times 2 Not at all -> ALC5 X Don't know -> ALC5 R Refused -> ALC5

Skip: ALC4a if (ALC1=3) Skip: ALC4a if (ALC1=X) Skip: ALC4a if (ALC1=R) Skip: ALC4a if (ALC3!=1)

ALC4a More than 11 male/7 female drinks in a day in past 4 weeks number of times

Existing Adult [ENTER NUMBER OF TIMES AND PRESS ENTER] number of times

Skip: ALC5 if (ALC4!=1) Skip: ALC5 if (ALC1=3) Skip: ALC5 if (ALC1=X) Skip: ALC5 if (ALC1=R) Skip: ALC5 if (ALC3!=1)

ALC5 7-10 male/5-6 female drinks in a day in the past 4 weeks

Existing Adult In the past 4 weeks how often have you had 7-10 (if male) or 5-6 (if female) drinks in a day? 1 Record number of times 2 Not at all -> ALCX X Don't know -> ALCX R Refused -> ALCX

Skip: ALC5a if (ALC1=3) Skip: ALC5a if (ALC1=X) Skip: ALC5a if (ALC1=R) Skip: ALC5a if (ALC3!=1)


of 106


Question Code



ALC5a 7-10 male/5-6 female drinks in a day in the past 4 weeks number of times

Existing Adult [ENTER NUMBER OF TIMES AND PRESS ENTER] number of times

Skip: ALCX if (ALC1=3) Skip: ALCX if (ALC1=X) Skip: ALCX if (ALC1=R) Skip: ALCX if (ALC3!=1) Skip: ALCX if (ALC5!=1)

ALCX End of alcohol frequency and consumption (skip only)

Existing Adult

HWTZ Start of height and weight BMI (skip only)

Existing 2+ years Skip: HWTX if (AGE<2)

HWT1 Height Existing 2+ years Now a few questions about your/child's height and weight. How tall are you/is child without shoes? 1 Record in centimetres OR 2 Record in Feet and Inches -> HWT1b X Don't know (probe for best estimate before accepting) -> HWT2 R Refused -> HWT2

HWT1a Height in centimetres

Existing 2+ years How tall are you/is child without shoes? Centimetres

Skip: HWT1b if (HWT1!=1)

HWT1b Height in feet Existing 2+ years How tall are you/is child without shoes? Feet

Skip: HWT1c if (HWT1!=2)

HWT1c Height in inches

Existing 2+ years How tall are you/is child without shoes? Inches

Skip: CALC1 if (HWT1!=2)

HWT2 Weight Existing 2+ years How much do you/does child weigh without clothes or shoes? 1 Answer in Kilograms OR 2 Answer in Stones and Pounds (14 pounds in a stone) -> HWT2b X Don't know (Probe for best estimate before accepting) -> HWT10 R Refused -> HWT10

HWT2a Weight in kilograms

Existing 2+ years How much do you/does child weigh without clothes or shoes? Kilograms


HWT2b Weight in stones

Existing 2+ years How much do you/does child weigh without clothes or shoes? Stones

Skip: HWT2bb if (HWT2!=2)

HWT2bb Weight in pounds

Existing 2+ years How much do you/does child weigh without clothes or shoes? Pounds

Skip: CALC2 if (HWT2!=2)


of 106


Question Code



HWT10 Waist measurement

Existing 2+ years What is your waist measurement? 1 Record in centimetres 2 Record in inches -> HWT10b X Don't know (probe for best estimate before accepting) -> HWT9 R Refused -> HWT9

Skip: HWT9 if (CHILD=1)

HWT10a Waist measurement in centimetres

Existing 2+ years What is your waist measurement? centimetres


HWT10b Waist measurement in inches

Existing 2+ years What is your waist measurement? Inches

Skip: HWT9 if (HWT10!=2)

HWT9 Agree to measure child

Existing 2+ years As you were unsure or did not know the height or weight of child would you be able to measure child and provide us with that information when we ring you back in the next few weeks? 1 Yes 2 No X Don't know R Refused

Skip: HWTX if (CHILD=2) Skip: HWTX if (PROXY=1) Skip: HWTX if (HWT2!=X)&(HWT2!=R)&(HWT1!=X)&(HWT1!=R)

HWTX End of height and weight BMI (skip only)

Existing 2+ years

NUTZ Start of nutrition 1 adult dietary guidelines (skip only)

Existing 2+ years Skip: NUTX if (AGE<2)

NUT Introduction to nutrition 1 (script only)

Existing 2+ years The next few questions are about food. [KEY "N" TO CONTINUE]

NUT1 Serves of vegetables usually eaten per day

Existing 2+ years How many serves of vegetables do you/does child usually eat each day? One serve is half a cup cooked or 1 cup of salad vegetables. 1 Answer in serves per day 2 Answer in serves per week -> NUT1b 3 Don't eat vegetables -> NUT2 X Don't know -> NUT2 R Refused -> NUT2

NUT1a How many serves of vegetables usually eaten per day

Existing 2+ years How many serves of vegetables do you/does child usually eat each day? One serve is half a cup cooked or 1 cup of salad vegetables. serves per day

Skip: NUT1b if (NUT1=2) Skip: NUT1b if (NUT1=3) Skip: NUT1b if (NUT1=X) Skip: NUT1b if (NUT1=R)


of 106


Question Code



NUT1b How many serves of vegetables usually eaten per week

Existing 2+ years How many serves of vegetables do you/does child usually eat each day? One serve is half a cup cooked or 1 cup of salad vegetables. serves per week

Skip: CALC4 if (NUT1=1) Skip: CALC4 if (NUT1=3) Skip: CALC4 if (NUT1=X) Skip: CALC4 if (NUT1=R)

NUT2 Serves of fruit usually eaten per day

Existing 2+ years How many serves of fruit do you/ does child usually eat each day? A serve is 1 medium piece or 2 small pieces of fruit or 1 cup of diced pieces. 1 Answer in serves per day 2 Answer in serves per week -> NUT2b 3 Don't eat fruit -> NUTX X Don't know -> NUTX R Refused -> NUTX

NUT2a How many serves of fruit usually eaten per day

Existing 2+ years How many serves of fruit do you/does child usually eat each day? A serve is 1 medium piece or 2 small pieces of fruit or 1 cup of diced pieces. serves per day

Skip: NUT2b if (NUT2=2) Skip: NUT2b if (NUT2=3) Skip: NUT2b if (NUT2=X) Skip: NUT2b if (NUT2=R)

NUT2b How many serves of fruit usually eaten per week

Existing 2+ years How many serves of fruit do you/does child usually eat each day? A serve is 1 medium piece or 2 small pieces of fruit or 1 cup of diced pieces. serves per week (0,1,2,3, etc.)

Skip: CALC5 if (NUT2=1) Skip: CALC5 if (NUT2=3) Skip: CALC5 if (NUT2=X) Skip: CALC5 if (NUT2=R)

NUTX End of nutrition 1 adult dietary guidelines (skip only)

Existing 2+ years

CNFZ Start of nutrition 2 child dietary guidelines (skip only)


Skip: CNFX if (AGE<2) Skip: CNFX if (CHILD=2) Skip: CNFX if (PROXY=1)


of 106


Question Code



NUT7 Times meat products usually eaten per week


Child 2-15 years

How often do you/does child eat processed meat products such as sausages, frankfurts, devon, salami, hamburgers, chicken nuggets, meat pies, bacon or ham? [LONGER LIST DO NOT PROMPT; frankfurters, salami, bacon, chicken roll, luncheon meats, delicatessen meats, meat paste, liver paste, pate, meat pies, sausage rolls, hamburger, saveloys, yeeros, hotdogs, rissoles, chorizo, canned meats, smoked chicken, other smoked meats] 1 Answer in times per day 2 Answer in times per week -> NUT7b 3 Answer in times per month -> NUT7c 4 Rarely or never -> NUT15 X Don't know -> NUT15 R Refused -> NUT15

NUT7a Number of times meat products usually eaten per day


Child 2-15 years

How often do you/does child eat processed meat products such as sausages, frankfurts, devon, salami, meat pies, bacon or ham? times per day

Skip: NUT7b if (NUT7=2) Skip: NUT7b if (NUT7=3) Skip: NUT7b if (NUT7=4) Skip: NUT7b if (NUT7=X) Skip: NUT7b if (NUT7=R)

NUT7b Number of times meat products usually eaten per week


Child 2-15 years

How often do you/does child eat processed meat products such as sausages, frankfurts, devon, salami, meat pies, bacon or ham? times per week

Skip: NUT7c if (NUT7=1) Skip: NUT7c if (NUT7=3) Skip: NUT7c if (NUT7=4) Skip: NUT7c if (NUT7=X) Skip: NUT7c if (NUT7=R)

NUT7c Number of times meat products usually eaten per month


Child 2-15 years

How often do you/does child eat processed meat products such as sausages, frankfurts, devon, salami, meat pies, bacon or ham? times per month

Skip: CALC11 if (NUT7=1) Skip: CALC11 if (NUT7=2) Skip: CALC11 if (NUT7=4) Skip: CALC11 if (NUT7=X) Skip: CALC11 if (NUT7=R)

NUT15 Times hot fried potato products usually eaten per week


Child 2-15 years

How often do you/does child eat hot chips, French fries, wedges or fried potatoes? 1 Answer in times per day 2 Answer in times per week -> NUT15b 3 Answer in times per month -> NUT15c 4 Rarely or never -> NUT16 X Don't know -> NUT16 R Refused -> NUT16


of 106


Question Code



NUT15a Number of times hot fried potato products usually eaten per day


Child 2-15 years

How often do you/does child eat hot chips, French fries, wedges or fried potatoes? times per day


NUT15b Number of times hot fried potato products usually eaten per week


Child 2-15 years

How often do you/does child eat hot chips, French fries, wedges or fried potatoes? times per week


NUT15c Number of times hot fried potato products usually eaten per month


Child 2-15 years

How often do you/does child eat hot chips, French fries, wedges or fried potatoes? times per month


NUT16 Times fried and salty snack products usually eaten per week


Child 2-15 years

How often do you/does child eat potato crisps or other salty snacks such as Twisties or corn chips? 1 Answer in times per day 2 Answer in times per week -> NUT16b 3 Answer in times per month -> NUT16c 4 Rarely or never -> NUT6 X Don't know -> NUT6 R Refused -> NUT6

NUT16a Number of times salty snack products usually eaten per day


Child 2-15 years

How often do you/does child eat potato crisps or other salty snacks such as Twisties or corn chips? times per day



of 106


Question Code



NUT16b Number of times salty snack products usually eaten per week


Child 2-15 years

How often do you/does child eat potato crisps or other salty snacks such as Twisties or corn chips? times per week


NUT16c Number of times salty snack products usually eaten per month


Child 2-15 years

How often do you/does child eat potato crisps or other salty snacks such as Twisties or corn chips? times per month


NUT6 Type of milk usually have


Child 2-15 years

What type of milk do you/does child USUALLY have? 1 Regular milk (whole or full cream/dairy/soy/goats) 2 Low /reduced fat milk (dairy/soy/goat) 3 Skim milk (dairy/soy/goat) 4 Evaporated or sweetened milk 5 Other [SPECIFY] 6 Don't have milk X Don't know R Refused

CNFI15 Cups of cordial per day


Child 2-15 years

How many cups of soft drink, cordials or sports drink, such as lemonade or Gatorade, do you/does child usually drink in a day? 1 cup=250ml. One can of soft drink = 1.5 cups. One 500ml bottle of Gatorade = 2 cups. 1 Cups per day 2 Cups per week -> CNFI15b 3 Doesn't drink soft drink -> NUT13 X Don't know -> NUT13 R Refused -> NUT13

CNFI15a Number of cups of cordial per day


Child 2-15 years

How many cups of soft drink, cordials or sports drink, such as lemonade or Gatorade, do you/does child usually drink in a day? 1 cup=250ml. 1 can of soft drink = 1.5 cups. 1 500ml bottle of Gatorade = 2 cups. cups per day

Skip: CNFI15b if (CNFI15!=1)


of 106


Question Code



CNFI15b Number of cups of cordial per week


Child 2-15 years

How many cups of soft drink, cordials or sports drink, such as lemonade or Gatorade, do you/does child usually drink in a day? 1 cup=250ml. 1 can of soft drink = 1.5 cups. 1 500ml bottle of Gatorade = 2 cups. cups per week

Skip: NUT13 if (CNFI15!=2)

NUT13 Fast food consumption


Child 2-15 years

How often do you/does child have meals or snacks such as burgers, pizza, chicken or chips from places like McDonalds, Hungry Jacks, Pizza Hut, KFC, Red Rooster, or local take-away places? 1 Times per week 2 Times per month -> NUT13b 3 Rarely/Never -> CNFI6 X Don't know -> CNFI6 R Refused -> CNFI6

NUT13a Fast food consumption per week


Child 2-15 years

How often do you/does child have meals or snacks such as burgers, pizza, chicken or chips from places like McDonalds, Hungry Jacks, Pizza Hut, KFC, Red Rooster, or local take-away places? times per week

Skip: NUT13b if (NUT13!=1)

NUT13b Fast food consumption per month


Child 2-15 years

How often do you/does child have meals or snacks such as burgers, pizza, chicken or chips from places like McDonalds, Hungry Jacks, Pizza Hut, KFC, Red Rooster, or local take-away places? times per month

Skip: CNFI6 if (NUT13!=2)

CNFI6 Cups of fruit juice


Child 2-15 years

How many cups of fruit juice do you/does child usually drink in a day? 1 cup=250ml, a household tea cup or large popper 1 Answer in cups per day 2 Answer in cups per week -> CNFI6b 3 Doesn't drink juice -> CNFI14 X Don't know -> CNFI14 R Refused -> CNFI14

CNFI6a Cups of fruit juice per day


Child 2-15 years

How many cups of fruit juice do you/does child usually drink in a day? 1 cup=250ml, a household tea cup or large popper cups per day


CNFI6b Cups of fruit juice per week


Child 2-15 years

How many cups of fruit juice do you/does child usually drink in a day? 1 cup=250ml, a household tea cup or large popper cups per week

Skip: CNFI14 if (CNFI6!=2)


of 106


Question Code



CNFI14 Cups of water drunk per day


Child 2-15 years

How many cups of water do you/does child usually drink in a day? 1 cup=250ml or a household tea cup. 1 average bottle of water = 1.5 cups. 1 Number of cups per day 2 Number of cups per week -> CNFI14b 3 Doesn't drink water -> NUT12 X Don't know -> NUT12 R Refused -> NUT12

CNFI14a Cups of water drunk per day


Child 2-15 years

How many cups of water do you/does child usually drink in a day? 1 cup=250ml or a household tea cup. One average bottle of water = 1.5 cups. cups per day


CNFI14b Cups of water drunk per week


Child 2-15 years

How many cups of water do you/does child usually drink in a day? 1 cup=250ml or a household tea cup. One average bottle of water = 1.5 cups. cups per week

Skip: NUT12 if (CNFI14!=2)

NUT12 Red meat consumption


Child 2-15 years

How often do you/does child eat red meat such as beef, lamb, liver and kidney but not pork or ham? 1 Answer in times per day 2 Answer in times per week -> NUT12b 3 Answer in times per month -> NUT12c 4 Rarely/never -> CNFI5 X Don't know -> CNFI5 R Refused -> CNFI5

NUT12a Red meat consumption per day


Child 2-15 years

How often do you/does child eat red meat such as beef, lamb, liver and kidney but not pork or ham? times per day

Skip: NUT12b if (NUT12!=1)

NUT12b Red meat consumption per week


Child 2-15 years

How often do you/does child eat red meat such as beef, lamb, liver and kidney but not pork or ham? times per week

Skip: NUT12c if (NUT12!=2)

NUT12c Red meat consumption per month


Child 2-15 years

How often do you/does child eat red meat such as beef, lamb, liver and kidney but not pork or ham? times per month

Skip: CNFI5 if (NUT12!=3)


of 106


Question Code



CNFI5 Cups of milk drunk


How many cups of milk does child usually drink in a day? 1 cup=250ml, a household tea cup [PROMPT; Milk means cow's milk.] [IF CHILD DRINKS OTHER MILK SUCH AS SOYMILK USE RESPONSE OPTION 3] 1 Answer in cups per day 2 Answer in cups per week -> CNFI5b 3 Drinks other milk such as soy milk (SPECIFY) -> CNFI11 4 Doesn't drink cow's milk or other milk -> CNFI11 X Don't know -> CNFI11 R Refused -> CNFI11

Skip: CNFI11 if (NUT6=6)

CNFI5a Cups of milk drunk each day


How many cups of milk does child usually drink in a day? 1 cup=250ml, a household tea cup cups per day


CNFI5b Cups of milk drunk each week


How many cups of milk does child usually drink in a day? 1 cup=250ml, a household tea cup cups per week


CNFI11 Serves of yoghurt eaten


How many serves of yoghurt does child usually have in a day? 1 serve is 200gms yoghurt 1 Answer in serves per day 2 Answer in serves per week -> CNFI11b 3 Has yoghurt less than once a week/Not at all -> CNFI12 X Don't know -> CNFI12 R Refused -> CNFI12

CNFI11a Serves of yoghurt eaten daily


How many serves of yoghurt does child usually have in a day? 1 serve is 200gms yoghurt serves per day


CNFI11b Serves of yoghurt eaten weekly


How many serves of yoghurt does child usually have in a day? 1 serve is 200gms yoghurt serves per week



of 106


Question Code



CNFI12 Serves of custard eaten


How many serves of custard does child usually have in a day? 1 serve is 250 mls custard 1 Answer in serves per day 2 Answer in serves per week -> CNFI12b 3 Has custard less than once a week/Not at all -> CNFI13 X Don't know -> CNFI13 R Refused -> CNFI13

CNFI12a Serves of custard eaten daily


How many serves of custard does child usually have in a day? 1 serve is 250 mls custard serves per day


CNFI12b Serves of custard eaten weekly


How many serves of custard does child usually have in a day? 1 serve is 250 mls custard serves per week


CNFI13 Serves of cheese eaten


How many serves of cheese does child usually have in a day? 1 serve is 40g cheese 1 Answer in serves per day 2 Answer in serves per week -> CNFI13b 3 Has cheese less than once a week/Not at all -> N8 X Don't know -> N8 R Refused -> N8

CNFI13a Serves of cheese eaten daily


How many serves of cheese does child usually have in a day? 1 serve is 40g cheese serves per day


CNFI13b Serves of cheese eaten weekly


How many serves of cheese does child usually have in a day? 1 serve is 40g cheese serves per week

Skip: N8 if (CNFI13!=2)

N8 Biscuit, cake, doughnut, muesli bar consumption


How often does child usually eat sweet and savoury biscuits, cakes, donuts, or muesli bars? 1 Record times per day 2 Record times per week -> N8b 3 Record times per month -> N8c 4 Rarely or never -> CNFI16 X Don't Know -> CNFI16 R Refused -> CNFI16


of 106


Question Code



N8a Biscuit, cake, doughnut, muesli bar daily consumption


How often does child usually eat sweet and savoury biscuits, cakes, donuts, or muesli bars? times per day

Skip: N8b if (N8!=1)

N8b Biscuit, cake, doughnut, muesli bar weekly consumption


How often does child usually eat sweet and savoury biscuits, cakes, donuts, or muesli bars? times per week

Skip: N8c if (N8!=2)

N8c Biscuit, cake, doughnut, muesli bar monthly consumption


How often does child usually eat sweet and savoury biscuits, cakes, donuts, or muesli bars? times per month

Skip: CNFI16 if (N8!=3)

CNFI16 Confectionary Consumption


How often does child usually eat confectionary including chocolate, confectionary bars and lollies? 1 Record times per day 2 Record times per week -> CNFI16b 3 Record times per month -> CNFI16c 4 Rarely or never -> NUT19a X Don't Know -> NUT19a R Refused -> NUT19a

CNFI16a Times confectionary usually eaten per day


How often does child eat confectionary including chocolate, confectionary bars and lollies? times per day


CNFI16b Times confectionary usually eaten per week


How often does child eat confectionary including chocolate, confectionary bars and lollies? times per week

Skip: CNFI16c if (CNFI16!=2)

CNFI16c Times confectionary usually eaten per month


How often does child eat confectionary including chocolate, confectionary bars and lollies? times per month

Skip: NUT19a if (CNFI16!=3)

NUT19a Eating at table with family


How often does your family eat together at the table? 1 Record in times per day 2 Record in times per week -> NUT19ba 3 None/Never -> NUT20Ca X Don't know -> NUT20Ca R Refused -> NUT20Ca

NUT19aa Eating daily at table with family


How often does your family eat together at the table? times per day

Skip: NUT19ba if (NUT19a!=1)

NUT19ba Eating weekly at table with family


How often does your family eat together at the table? times per week

Skip: NUT20Ca if (NUT19a!=2)


of 106


Question Code



NUT20Ca Eating dinner in front of the television


How often does child usually have dinner in front of the TV? 1 Record in times per day 2 Record in times per week -> NUT20Cba 3 None/Never -> N16 X Don't know -> N16 R Refused -> N16

NUT20Caa Eating dinner daily in front of the television


How often does child usually have dinner in front of the TV? times per day

Skip: NUT20Cba if (NUT20Ca!=1)

NUT20Cba Eating dinner weekly in front of the television


How often does child usually have dinner in front of the TV? times per week

Skip: N16 if (NUT20Ca!=2)

N16 Frequency of eating breakfast


How often does child usually have something to eat for breakfast? 1 Every Day 2 Almost Every Day (5-6 times per week) 3 Less than daily (2-4 times per week) 4 Hardly ever (0-1 times per week) X Don't know R Refused

PFF3 Frequency of offering water during meals


How often do you offer child water to drink with meals or snacks? [READ OUT] 1 Usually 2 Sometimes 3 Never / Rarely X Don't know R Refused

PFF4 Frequency of confectionery as a reward


How often do you offer sweets such as lollies, ice cream, cake or biscuits to child as a reward for good behaviour? [READ OUT] 1 Usually 2 Sometimes 3 Never / Rarely X Don't know R Refused

Skip: CNFX if (CNFI16=4)

CNFX End of nutrition 2 child dietary guidelines (skip only)



of 106


Question Code



FSCZ Start of food security (skip only)

Existing Child Skip: FSCX if (CHILD=2) Skip: FSCX if (PROXY=1)

FSC1 Food insecurity in the last 12 months

Existing Child In the last twelve months, were there any times that you ran out of food and couldn't afford to buy more? 1 Yes 2 No -> FSCX X Don't know -> FSCX R Refused -> FSCX

FSC2 Coping methods for feeding children when lack of food security in the last 12 months

Existing Child How do you cope with feeding child when this happens? [MULTIPLE RESPONSE] Parent/guardian skips meals or eats less Children/child skip meals or eat less Cut down on variety of foods family eats Seek help from relatives Seek help from friends Seek help from Government / Social Security Seek help from welfare agencies Other [SPECIFY] Don't know Refusal

Skip: FSC3 if (FSC1!=1) Skip: FSC3 if (CHILD=2) Skip: FSC3 if (PROXY=1)

FSC3 Request help to ensure family has food security

Existing Child There are a number of agencies that can help with making sure your family has enough food. Would you like the phone numbers of these agencies? 1 Yes [Refer to list] 2 No X Don't know R Refused

Skip: FSCX if (FSC1!=1) Skip: FSCX if (CHILD=2) Skip: FSCX if (PROXY=1)

FSCX End of food security (skip only)

Existing Child

AMHZ Start of mental health 1 (adult psychological distress) (skip only)

Returning from 2011

Adults Skip: AMHX if (AGE<16)

AMH Adult mental health introduction (script only)

Returning from 2011

Adults The next questions are about how you have been feeling in the past 4 weeks. [KEY "N" TO CONTINUE]


of 106


Question Code



AMH1 K10 - Tired for no good reason in past 4 weeks

Returning from 2011

Adults In the past 4 weeks, about how often did you feel tired out for no good reason? [READ OUT] 1 All of the time 2 Most of the time 3 Some of the time 4 A little of the time 5 None of the time X Don't know R Refused

AMH2 K10 - Feel nervous in past 4 weeks

Returning from 2011

Adults In the past 4 weeks, about how often did you feel nervous? [READ OUT] 1 All of the time 2 Most of the time 3 Some of the time 4 A little of the time 5 None of the time -> AMH4 X Don't know -> AMH4 R Refused -> AMH4

AMH3 K10 - Feel so nervous that nothing can calm you in past 4 weeks

Returning from 2011

Adults In the past 4 weeks, about how often did you feel so nervous that nothing could calm you down? [READ OUT] 1 All of the time 2 Most of the time 3 Some of the time 4 A little of the time 5 None of the time X Don't know R Refused

Skip: AMH4 if ((AMH2=5) Skip: AMH4 if (AMH2=X) Skip: AMH4 if (AMH2=R)

AMH4 K10 - Feel hopeless in past 4 weeks

Returning from 2011

Adults In the past 4 weeks, about how often did you feel hopeless? [READ OUT] 1 All of the time 2 Most of the time 3 Some of the time 4 A little of the time 5 None of the time X Don't know R Refused


of 106


Question Code



AMH5 K10 - Feel restless or fidgety in past 4 weeks

Returning from 2011

Adults In the past 4 weeks, about how often did you feel restless or fidgety? [READ OUT] 1 All of the time 2 Most of the time 3 Some of the time 4 A little of the time 5 None of the time -> AMH7 X Don't know -> AMH7 R Refused -> AMH7

AMH6 K10 - Feel so restless couldn't sit still in past 4 weeks

Returning from 2011

Adults In the past 4 weeks, about how often did you feel so restless you could not sit still? [READ OUT] 1 All of the time 2 Most of the time 3 Some of the time 4 A little of the time 5 None of the time X Don't know R Refused

Skip: AMH7 if ((AMH5=5) Skip: AMH7 if (AMH5=X) Skip: AMH7 if (AMH5=R)

AMH7 K10 - Feel depressed in past 4 weeks

Returning from 2011

Adults In the past 4 weeks, about how often did you feel depressed? [READ OUT] 1 All of the time 2 Most of the time 3 Some of the time 4 A little of the time 5 None of the time X Don't know R Refused

AMH8 K10 - Feel everything was an effort in past 4 weeks

Returning from 2011

Adults In the past 4 weeks, about how often did you feel that everything was an effort? [READ OUT] 1 All of the time 2 Most of the time 3 Some of the time 4 A little of the time 5 None of the time X Don't know R Refused


of 106


Question Code



AMH9 Feel so sad nothing could cheer you up in past 4 weeks

Returning from 2011

Adults In the past 4 weeks, about how often did you feel so sad that nothing could cheer you up? [READ OUT] 1 All of the time 2 Most of the time 3 Some of the time 4 A little of the time 5 None of the time X Don't know R Refused

AMH10 K10 - Feel worthless in past 4 weeks

Returning from 2011

Adults In the past 4 weeks, about how often did you feel worthless? [READ OUT] 1 All of the time 2 Most of the time 3 Some of the time 4 A little of the time 5 None of the time X Don't know R Refused

PSD1 Days unable to undertake daily activities because of psychological distress

Returning from 2011

Adults In the last 4 weeks, how many days were you TOTALLY UNABLE to work, study or manage your day-to-day activities because of these feelings? number of days 88888 Don't know 99999 Refused

Skip: PSD2 if (AMHT<15)

PSD2 Days reduced daily activities because of psychological distress in past 4 weeks

Returning from 2011

Adults Aside from those days In the last 4 weeks, HOW MANY DAYS were you able to work, study or manage your day-to-day activities, but had to CUT DOWN on what you did because of these feelings? number of days 88888 Don't know 99999 Refused

Skip: PSD3 if (PSD1=28) Skip: PSD3 if (PSD1=88888) Skip: PSD3 if (PSD1=99999) Skip: PSD3 if (AMHT<15)

PSD3 Number of visits to health professionals for psychological distress in past 4 weeks

Returning from 2011

Adults In the last 4 weeks, how many times were you seen a doctor or other health professional about these feelings? number of consultations 88888 Don't know 99999 Refused

Skip: PSD4 if (AMHT<15)


of 106


Question Code



PSD4 Times that physical problems have been the cause of psychological distress

Returning from 2011

Adults In the last 4 weeks, how often have physical health problems been the main cause of these feelings? [READ OUT] 1 All of the time 2 Most of the time 3 Some of the time 4 A little of the time 5 None of the time X Don't know R Refused

Skip: AMHXa if (AMHT<15)

AMHXa Lifeline contact number

Returning from 2011

Adults If at any time you are experiencing personal distress and would like crisis support you can call Lifeline on 13 11 14 [KEY N TO CONTINUE]

Skip: AMHX if (AMHT<15)

AMHX End of mental health 1 (adult psychological distress) (skip only)

Returning from 2011

Adults

STRZ Start of mental health 2 childhood strengths and difficulties (skip only)


Skip: STRX if (AGE>15) Skip: STRX if (AGE<4) Skip: STRX if (DEM2=1)&(DEM2b<6)

STR Strengths and difficulties (script only)


The next section is about child's personality and behaviour. For each statement please tell me if it is not true, somewhat true or certainly true for child over the past six months. [KEY "N" TO CONTINUE]

STR1 Considerate of other people's feelings


Child is considerate of other people's feelings. Is that... [READ OUT] 1 Not true 2 Somewhat true 3 Certainly true X Don't know R Refused


of 106


Question Code



STR2 Restless, overactive


Child is restless, overactive or cannot stay still for long. Is that... [READ OUT] 1 Not true 2 Somewhat true 3 Certainly true X Don't know R Refused

STR3 Often complains of sickness


Child often complains of headaches, stomach-aches or sickness. Is that... [READ OUT] 1 Not true 2 Somewhat true 3 Certainly true X Don't know R Refused

STR4a Child shares readily


Child shares readily with other children, for example toys, treats and pencils. Is that... [READ OUT] 1 Not true 2 Somewhat true 3 Certainly true X Don't know R Refused

Skip: STR4b if (AGE>10)

STR4b Youth shared readily


Child shares readily with other young people, for example CDs, games and food. Is that... [READ OUT] 1 Not true 2 Somewhat true 3 Certainly true X Don't know R Refused

Skip: STR5 if (AGE<11)


of 106


Question Code



STR5 Often loses temper


Child often loses their temper. Is that... [READ OUT] 1 Not true 2 Somewhat true 3 Certainly true X Don't know R Refused

STR6a Child prefers to be alone


Child is rather solitary or prefers to play alone. Is that... [READ OUT] 1 Not true 2 Somewhat true 3 Certainly true X Don't know R Refused


STR6b Youth prefers to be alone


Child would rather be alone than with other young people. Is that... [READ OUT] 1 Not true 2 Somewhat true 3 Certainly true X Don't know R Refused


STR7 Generally well behaved


Child is generally well behaved and usually does what adults request. Is that... [READ OUT] 1 Not true 2 Somewhat true 3 Certainly true X Don't know R Refused

STR8 Often seems worried


Child has many worries or often seems worried. Is that... [READ OUT] 1 Not true 2 Somewhat true 3 Certainly true X Don't know R Refused


of 106


Question Code



STR9 Helpful if someone is hurt, upset or feeling ill


Child is helpful if someone is hurt, upset or feeling ill. Is that... [READ OUT] 1 Not true 2 Somewhat true 3 Certainly true X Don't know R Refused

STR10 Constantly fidgeting or squirming


Child is constantly fidgeting or squirming. Is that... [READ OUT] 1 Not true 2 Somewhat true 3 Certainly true X Don't know R Refused

STR11 Has at least one good friend


Child has at least one good friend. Is that... [READ OUT] 1 Not true 2 Somewhat true 3 Certainly true X Don't know R Refused

STR12a Child often fights with others


Child often fights with or bullies other children. Is that... [READ OUT] 1 Not true 2 Somewhat true 3 Certainly true X Don't know R Refused


STR12b Youth often fights with others


Child often fights with or bullies other young people. Is that... [READ OUT] 1 Not true 2 Somewhat true 3 Certainly true X Don't know R Refused



of 106


Question Code



STR13 Often unhappy, depressed or tearful


Child is often unhappy, depressed or tearful. Is that... [READ OUT] 1 Not true 2 Somewhat true 3 Certainly true X Don't know R Refused

STR14a Child generally liked by others


Child is generally liked by other children. Is that... [READ OUT] 1 Not true 2 Somewhat true 3 Certainly true X Don't know R Refused


STR14b Youth generally liked by others


Child is generally liked by other young people. Is that... [READ OUT] 1 Not true 2 Somewhat true 3 Certainly true X Don't know R Refused


STR15 Easily distracted


Child is easily distracted or their concentration wanders. Is that... [READ OUT] 1 Not true 2 Somewhat true 3 Certainly true X Don't know R Refused

STR16a Child easily loses confidence


Child is nervous or clingy in new situations or easily loses confidence. Is that... [READ OUT] 1 Not true 2 Somewhat true 3 Certainly true X Don't know R Refused



of 106


Question Code



STR16b Youth easily loses confidence


Child is nervous in new situations or easily loses confidence. Is that... [READ OUT] 1 Not true 2 Somewhat true 3 Certainly true X Don't know R Refused


STR17 Kind to younger children


Child is kind to younger children. Is that... [READ OUT] 1 Not true 2 Somewhat true 3 Certainly true X Don't know R Refused

STR18 Often lies or cheats


Child often lies or cheats. Is that... [READ OUT] 1 Not true 2 Somewhat true 3 Certainly true X Don't know R Refused

STR19a Child picked on or bullied by others


Child is picked on or bullied by other children. Is that... [READ OUT] 1 Not true 2 Somewhat true 3 Certainly true X Don't know R Refused


STR19b Youth picked on or bullied by others


Child is picked on or bullied by other young people. Is that... [READ OUT] 1 Not true 2 Somewhat true 3 Certainly true X Don't know R Refused

Skip: STR20a if (AGE<11)


of 106


Question Code



STR20a Child often offers to help others


Child often volunteers to help others such as parents, teachers or other children. Is that... [READ OUT] 1 Not true 2 Somewhat true 3 Certainly true X Don't know R Refused


STR20b Youth often offers to help others


Child often volunteers to help others such as parents, teachers or children. Is that... [READ OUT] 1 Not true 2 Somewhat true 3 Certainly true X Don't know R Refused


STR21 Thinks things out before acting


Child thinks things out before acting. Is that... [READ OUT] 1 Not true 2 Somewhat true 3 Certainly true X Don't know R Refused

STR22 Steals Existing Child 4-15 years

Child steals from home, school or elsewhere. Is that... [READ OUT] 1 Not true 2 Somewhat true 3 Certainly true X Don't know R Refused

STR23a Child gets along better with adults than with other children


Child gets along better with adults than with other children. Is that.... [READ OUT] 1 Not true 2 Somewhat true 3 Certainly true X Don't know R Refused



of 106


Question Code



STR23b Youth gets along better with adults than with other children


Child gets along better with adults than with other young people. Is that... [READ OUT] 1 Not true 2 Somewhat true 3 Certainly true X Don't know R Refused


STR24 Many fears, easily scared


Child has many fears or is easily scared. Is that... [READ OUT] 1 Not true 2 Somewhat true 3 Certainly true X Don't know R Refused

STR25 Good attention span


Child has a good attention span and sees chores or homework through to the end. Is that... [READ OUT] 1 Not true 2 Somewhat true 3 Certainly true X Don't know R Refused

STR36 Teacher complains of overactivity


Over the last six months, have child's teachers complained of fidgetiness, restlessness or overactivity? [READ OUT] 1 Not true 2 Somewhat true 3 Certainly true X Don't know R Refused


of 106


Question Code



STR37 Teacher complains of poor concentration


Over the last six months, have child's teachers complained of their poor concentration or easily being distracted? [READ OUT] 1 Not true 2 Somewhat true 3 Certainly true X Don't know R Refused

STR38 Teacher complains of impulsivity


Over the last six months, have child's teachers complained of him/her acting without thinking about what he/she is doing, frequently butting in, or not waiting his/her turn? [READ OUT] 1 Not true 2 Somewhat true 3 Certainly true X Don't know R Refused

STR26 Overall difficulties


Overall do you think that child has difficulties in any of the following areas: emotions, concentration, behaviour or being able to get along with other people? [READ OUT] 1 No -> STRX 2 Yes - minor difficulties 3 Yes - definite difficulties 4 Yes - severe difficulties X Don't know R Refused

STR27 Duration of difficulties


How long have these difficulties been present? [READ OUT] 1 Less than a month 2 1 - 5 months 3 6 - 12 months 4 Over a year X Don't know R Refused

Skip: STR28 if (STR26=1)


of 106


Question Code



STR28 Amount of distress to child


How much do these difficulties upset or distress child? [READ OUT] 1 Not at all 2 A little 3 A medium amount 4 A great deal X Don't know R Refused


STR29 Interferes with home life


How much do these difficulties interfere with child's everyday home life? [READ OUT] 1 Not at all 2 A little 3 A medium amount 4 A great deal X Don't know R Refused


STR30 Interferes with friendships


How much do these difficulties interfere with child's friendships? [READ OUT] 1 Not at all 2 A little 3 A medium amount 4 A great deal X Don't know R Refused


STR31 Interferes with classroom learning


How much do these difficulties interfere with child's classroom learning? [READ OUT] 1 Not at all 2 A little 3 A medium amount 4 A great deal X Don't know R Refused



of 106


Question Code



STR32 Interferes with leisure activities


How much do these difficulties interfere with child's leisure activities? [READ OUT] 1 Not at all 2 A little 3 A medium amount 4 A great deal X Don't know R Refused


STR33 Difficulties put a burden on you or the family


How much do these difficulties put a burden on you or your family as a whole? [READ OUT] 1 Not at all 2 A little 3 A medium amount 4 A great deal X Don't know R Refused

Skip: STRXa if (STR26=1)

STRXa Kids Helpline contact number


If your child is experiencing challenges or distress they can always phone Kids HelpLine on 1800 55 1800 to talk with someone. [INT NOTE: If parent/main carer requests a number for themselves, then provide the Parent Line number of 1300 1300 52] [KEY N TO CONTINUE]

Skip: STRX if (STR26=1)

STRX End of mental health 2 childhood strengths and difficulties (skip only)


SOCZ Start of social capital (safety, trust, reciprocity & participation) (skip only)

Returning from 2011

Adult Skip: SOCX if (AGE<16)

SOC Intro social capital (safety, trust, reciprocity & participation) (script only)

Returning from 2011

Adult The next questions are about your involvement in your local community and neighbourhood. [KEY "N" TO CONTINUE]


of 106


Question Code



SOC12 Participate in group cultural or artistic activity

Returning from 2011

Adult In the last 12 months, have you participated in any of the following activities? [READ OUT] Recreational group or cultural group activities Community or special interest group activities Church or religious activities Went out to a cafe, restaurant or bar Took part in sport or physical activities Attended a sporting event as a spectator Visited a library, museum or art gallery Attended the movies, a theatre or a concert Visited a park, botanic gardens, zoo or theme park None of these activities Don't know Refused

SOC3 Participation in sporting or social club

Returning from 2011

Adult Are you an active member of a local organisation, church or club, such as a sport, craft, or social club? [READ OUT] 1 Yes, very active 2 Yes, somewhat active 3 Yes, a little active 4 No, not an active member X Don't know R Refused

SOC7 Reciprocity in caring for child

Returning from 2011

Adult If you were caring for a child and needed to go out for a while, and could not take the child with you, would you ask someone in your neighbourhood for help? [READ OUT] 1 Yes, definitely 2 Yes, possibly 3 No, probably not 4 No, definitely not X Don't know R Refused


of 106


Question Code



SOC8 Reciprocity in visiting neighbours

Returning from 2011

Adult How often have you visited someone in your neighbourhood in the past week? [READ OUT] 1 Frequently 2 A few times 3 At least once 4 Never (in the last week) X Don't know R Refused

SOC9 Reciprocity in many friends in local area

Returning from 2011

Adult When you go shopping in your local area how often are you likely to run into friends and acquaintances? [READ OUT] 1 Nearly always 2 Most of the time 3 Some of the time 4 Rarely or never X Don't know R Refused

SOC10 Reciprocity: sad to leave

Returning from 2011

Adult Would you be sad if you had to leave this neighbourhood? 1 Yes 2 No X Don't know R Refused

SOC5 Trust Returning from 2011

Adult I'm now going to read you some statements about safety in your local area. Can you tell me if you agree or disagree with these statements? Most people can be trusted. Do you? [READ OUT] 1 Strongly agree 2 Agree 3 Disagree 4 Strongly disagree X Don't know R Refused


of 106


Question Code



SOC4 Safety in street after dark

Returning from 2011

Adult I feel safe walking down your street after dark. Do you? [READ OUT] 1 Strongly agree 2 Agree 3 Disagree 4 Strongly disagree X Don't know R Refused

SOC6 Safety in local area

Returning from 2011

Adult My area has a reputation for being a safe place. Do you? [READ OUT] 1 Strongly agree 2 Agree 3 Disagree 4 Strongly disagree X Don't know R Refused

SOCX End of social capital (safety, trust, reciprocity & participation) (skip only)

Returning from 2011

Adult

IMMZ Start of immunisation 1 influenza and pneumococcal (skip only)

Existing All

IMM Next questions are about immunization (script only)

Existing All I now have a few questions about immunisation. [KEY "N" TO CONTINUE]

Skip: IMM4a if (DEM2=1)&(DEM2b<6)


of 106


Question Code



IMM2 Vaccinated against influenza in last 12 months

Existing All Were you/was child vaccinated or immunised against flu in the past 12 months? [IF NEEDED: Influenza vaccination is strongly recommended for people aged 65 years and over, Aboriginal and Torres Strait Islander people aged 15 years and over, people aged 6 months or over with conditions predisposing to severe influenza, as well as for people who may transmit influenza to those at high risk, who provide essential services. People aged 65 and over have been eligible for free vaccine for many years and since July 18 2009 Aboriginal and Torres Strait Islander people and pregnant women will also be able to receive free flu vaccine] 1 Yes 2 No -> IMM4a X Don't know -> IMM4a R Refused -> IMM4a

IMM2aa Year vaccinated against influenza

Existing All In which month and year were you/was child vaccinated? [INTERVIWER NOTE CONFIRM CORRECT SELECTION ON YEAR AND MONTH] 1 This year 2 Last year X Don't know R Refused

Skip: IMM2ab if (IMM2!=1)

IMM2ab Month vaccinated against influenza

Existing All MONTH VACCINATED or IMMUNIZED [INTERVIWER NOTE CONFIRM CORRECT SELECTION ON YEAR AND MONTH] 1 January 2 February 3 March 4 April 5 May 6 June 7 July 8 August 9 September 10 October 11 November 12 December 88888 Don't know 99999 Refused

Skip: IMM4a if (IMM2!=1)


of 106


Question Code



When last pneumococcal vaccination

Existing All When were you vaccinated or immunised against pneumonia? 1 Within the last 12 months 2 12 months to 5 years ago 3 More than 5 years ago 4 Never vaccinated X Don't know R Refused

Skip: IMMX if (AGE<50)

IMMX End of immunisation 1 influenza and pneumococcal (skip only)

Existing All

PRTZ Start of pertussis evaluation (skip only)

Existing All Skip: PRTX if (LOTE!=1)

PRT5 Had adult whooping cough booster in past 12 months

Existing All Have you had the ADULT whooping cough vaccine in the last 12 months? 1 Yes 2 No X Don't know R Refused

PRTX End of pertussis evaluation (skip only)

Existing All

HIVZ Start of HIV test questions

Existing Adult Skip: HIVX if (CHILD=1)

HIVINT Introduction to HIV test question

New in 2013 (4th quarter only)

Adult As you may know, there is a blood test that tells you whether or not you have HIV, the virus that causes AIDS. [KEY N TO CONTINUE]

HIVyr HIV test in last 12 months


Adult Have you had a blood test for HIV in the last 12 months? [INTERVIEWER NOTE: Campaigns on HIV detection, treatment and prevention are run within our community and this question allows us to better understand the effectiveness of our efforts among population groups] IF ASKED: Sexual Health Information Line: (02)9382 7440 or free-call 1800 451 624 (outside Sydney). 1 Yes 2 No X Don't know R Refused


of 106


Question Code



SEXID Sexual identity


Adult Do you think of yourself as: [READ OUT] [INTERVIEWER NOTE: Campaigns on HIV detection, treatment and prevention are run within our community and these questions allow us to better understand the effectiveness of our efforts among population groups] IF ASKED: Sexual Health Information Line: (02)9382 7440 or free-call 1800 451 624 (outside Sydney). 1 Heterosexual or straight 2 Homosexual or Gay 3 Bisexual 4 Something else/other X Don't know R Refused

HIVX End of HIV test questions


Adult

ORALZ Start of oral health (skip only)

Returning from 2011

All

ORAL Introduction to oral health (script only)

Returning from 2011

All The next questions are about your/child's teeth and dental health. [KEY "N" TO CONTINUE]

OHE1 Any teeth missing

Returning from 2011

Adult Are any of your natural teeth missing? [INCLUDES WISDOM TEETH] [PROMPT IF NECESSARY] 1 Yes - have some natural teeth missing 2 Yes - have all natural teeth missing 3 No - have no natural teeth missing X Don't know R Refused

Skip: OHE6 if (AGE<16)


of 106


Question Code



OHE6 Time since last dental visit

Returning from 2011

All When did you/child last visit a dental professional about your/his/her teeth, dentures or gums? [A dental professional includes dentist, dental specialist, dental hygienist, dental therapist or oral health therapist] [READ OUT] 1 Less than 12 months ago 2 1 year to less than 2 years ago 3 2 to less than 5 years ago 4 5 to less than 10 years ago 5 10 years ago or more 6 Never X Don't know R Refused

OHE5 Most recent oral health problem

Returning from 2011

All What treatment did you/child receive at your/his/her last dental visit? Check up Dental filling Oral health education Amalgam replacement Root canal filling Crown Implant Tooth extraction Fluoride treatment Gum treatment Teeth straightened/braces New or replacement dentures Teeth cleaned Fissure sealant Whitening/bleaching Denture repair None - did not visit the dentist Surgery of the mouth/jaw Other treatment [Specify] Don't know Refused

Skip: OHE18 if (OHE6!=1)&(OHE6!=2)&(OHE6!=3)&(OHE6!=4)


of 106


Question Code



OHE17 Type of dental service last visited

Returning from 2011

All Was your/child's last dental visit made at a... [READ OUT] 1 Private dental practice 2 Community dental practice 3 Health fund dental clinic 4 Dental hospital 5 Any other place (SPECIFY) X Don't know R Refused

OHE17c Dental service satisfaction

Returning from 2011

All Overall, what do you think of the care you/child received at your/his/her most recent dental visit? [READ OUT] 1 Excellent 2 Very good 3 Good 4 Fair 5 Poor X Don't know R Refused

OHE17b Reasons for dental service dissatisfaction

Returning from 2011

All Could you briefly describe why you rated the care you/child received as fair/poor?

Skip: OHE18 if (OHE17c!=4)&(OHE17c!=5)

OHE18 Reasons for not visiting dentist in last 12 months

Returning from 2011

All Are there any reasons you/child did not visit a dentist in the last 12 months? [PROBE FOR REASONS - DO NOT PROMPT] Respondent has dentures Worried or afraid of going; don't like going Don't need to Hard to find time Can't find a dentist I like Too expensive Too far to go Long waiting lists Dentist has moved or retired Other (Specify) Don't know Refused

Skip: OHE19 if (OHE6=1)


of 106


Question Code



OHE19 Private dental cover

Returning from 2011

All Do you have private health insurance cover for your/child's dental expenses? 1 Yes 2 No X Don't know R Refused

OHE20 Payment arrangement for last dental visit

Returning from 2011

All Did the government or an insurance fund pay any part of the expenses for your/child's last dental visit? [PROMPT IF NECESSARY] 1 No - paid all own expenses 2 Yes - Insurance fund paid some, patient paid some 3 Yes - Insurance fund paid all, patient paid none 4 Yes - Government paid some, patient or insurance paid some 5 Yes - Government paid all, patient paid none 6 Other payment arrangement [SPECIFY] X Don't know R Refused

Skip: OHE22 if (OHE6!=1)&(OHE6!=2)&(OHE6!=3)&(OHE6!=4)

OHE21 Cost of last dental visit

Returning from 2011

All How much did your/child's last dental visit cost before any insurance rebate? $ 88888 Don't know 99999 Refused

OHE22 Oral facial pain in last month

Returning from 2011

All During the last month have you had pain in the face, jaw, temple, in front of the ear or in the ear? 1 Yes 2 No X Don't know R Refused

Skip: ORALX if (AGE<16)

ORALX End of oral health (skip only)

Returning from 2011

All

PHYSZ Start of physical activity 1 leisure time (skip only)

Existing Adult Skip: PHYSX if (CHILD=1)

PHYS Introduction to physical activity (script only)

Existing Adult Now I'm going to ask some questions about the physical activity you did in the LAST WEEK. [KEY "N" TO CONTINUE]


of 106


Question Code



PAC1 Number of times walked in last week

Existing Adult In the last week, how many times have you walked continuously for at least 10 minutes for recreation or exercise or to get to or from places? [IF ASKED INCLUDE ANY WALKING FOR SELF-TRANSPORT] Number of times 88888 Don't know 99999 Refused

PAC2 Hours spent walking in last week

Existing Adult What do you estimate was the total time you spent walking in this way in the last week? [IN HOURS AND MINUTES] hours 88888 Don't know 99999 Refused

Skip: PAC2b if (PAC1=0) Skip: PAC2b if (PAC1=88888) Skip: PAC2b if (PAC1=99999)

PAC2b Minutes spent walking in last week

Existing Adult What do you estimate was the total time you spent walking in this way in the last week? [IN HOURS AND MINUTES] minutes

Skip: CALC14 if (PAC1=0) Skip: CALC14 if (PAC1=88888) Skip: CALC14 if (PAC1=99999) Skip: CALC14 if (PAC2=88888) Skip: CALC14 if (PAC2=99999)

PAC3 Number of times did vigorous chores in last week

Existing Adult The next question does not include gardening. In the last week, how many times did you do any vigorous household chores which made you breathe harder or puff and pant? Number of times 88888 Don't Know 99999 Refused

Skip: PAC5a if (PAC3=88888) Skip: PAC5a if (PAC3=99999) Skip: PAC5a if (PAC3=0)

PAC4a Hours doing vigorous chores in last week

Existing Adult What do you estimate was the total time you spent doing these vigorous household chores in the last week? (In hours and minutes) Number of hours 88888 Don't Know 99999 Refused

Skip: CALC15 if (PAC4a=88888) Skip: CALC15 if (PAC4a=99999)


of 106


Question Code



PAC4b Minutes doing vigorous chores in last week

Existing Adult What do you estimate was the total time you spent doing these vigorous household chores in the last week? (In hours and minutes) Number of minutes

PAC5a Number of times did gardening/heavy yard work in last week

Existing Adult In the last week, how many times did you do any vigorous gardening or heavy work around the yard which made you breathe harder or puff and pant? number of times 88888 Don't Know 99999 Refused

Skip: PAC7 if (PAC5a=88888) Skip: PAC7 if (PAC5a=99999) Skip: PAC7 if (PAC5a=0)

PAC6a Hours spent doing gardening/heavy yard work

Existing Adult What do you estimate was the total time you spent doing vigorous gardening or heavy work around the yard in the last week? (In hours and minutes) number of hours 88888 Don't know 99999 Refused

Skip: CALC16 if (PAC6a=88888) Skip: CALC16 if (PAC6a=99999)

PAC6b Minutes spent doing gardening/heavy yard work

Existing Adult What do you estimate was the total time you spent doing vigorous gardening or heavy work around the yard in the last week? (In hours and minutes) number of minutes

PAC7 Number of times exercised vigorously in last week

Existing Adult The next question excludes household chores or gardening. In the last week, how many times did you do any vigorous physical activity which made you breathe harder or puff and pant? (eg: football, tennis, netball, squash, athletics, cycling, jogging, keep-fit exercises and vigorous swimming). number of times 88888 Don't know 99999 Refused

PAC8a Hours spent exercising vigorously in last week

Existing Adult What do you estimate was the total time you spent doing this vigorous physical activity in the last week? number of hours 88888 Don't know 99999 Refused



of 106


Question Code



PAC8b Minutes spent exercising vigorously in last week

Existing Adult What do you estimate was the total time you spent doing this vigorous physical activity in the last week? number of minutes

Skip: CALC17 if (PAC7=88888) Skip: CALC17 if (PAC7=99999) Skip: CALC17 if (PAC7=0) Skip: CALC17 if (PAC8a=88888) Skip: CALC17 if (PAC8a=99999)

PAC9 Number of times spent exercising moderately in last week

Existing Adult This next question does not include household chores or gardening. In the last week, how many times did you do any other more moderate physical activity that you haven't already mentioned? (e.g.: lawn bowls, golf, tai chi, and sailing). number of times 88888 Don't know 99999 Refused

PAC10a Hours spent exercising moderately in last week

Existing Adult What do you estimate was the total time that you spent doing these activities in the last week? number of hours 88888 Don't know 99999 Refused


PAC10b Minutes spent exercising moderately in last week

Existing Adult What do you estimate was the total time that you spent doing these activities in the last week? number of minutes

Skip: CALC18 if (PAC9=88888) Skip: CALC18 if (PAC9=99999) Skip: CALC18 if (PAC9=0) Skip: CALC18 if (PAC10a=88888) Skip: CALC18 if (PAC10a=99999)

PHYSX End of physical activity 1 leisure time (skip only)

Existing Adult


of 106


Question Code



CPINTZ Start of physical activity 3 child activity and inactivity (skip only)


Skip: CPINTX if (AGE<5) Skip: CPINTX if (CHILD=2) Skip: CPINTX if (PROXY=1)

CPINT Intro to child activity and inactivity (script only)


The next few questions are about child's physical activity and inactivity. [KEY "N" TO CONTINUE]

SP11 Sports and outdoor activities in last 12 months


In the past 12 months, what types of sports and activities did child play or do? Basketball Cricket Cycling/mountain biking/bike riding Dancing/Ballet Jogging/athletics/running Martial arts Netball Rugby League Rugby Union Skateboarding or Rollerblading Soccer Swimming Other (SPECIFY) Did not play any sport Don't know Refused

CPHY1 How many days during week usually does physical activity


On about how many days during the school week does child usually do physical activity outside of school hours? [NOTE: THIS INCLUDES BEFORE AND AFTER SCHOOL SPORTS] 1 Record days 2 None -> CPHY3 X Don't know -> CPHY3 R Refused -> CPHY3

CPHY1A Number of days during week usually does physical activity


On about how many days during the school week does child usually do physical activity outside of school hours? [NOTE: THIS INCLUDES BEFORE AND AFTER SCHOOL SPORTS] days

Skip: CPHY2 if (CPHY1!=1)

CPHY2 How many hours during week usually does physical activity


On those days, about how many hours does child usually do physical activity? 1 Record hours and minutes X Don't know -> CPHY3 R Refused -> CPHY3

Skip: CPHY2a if (CPHY1!=1)


of 106


Question Code



CPHY2a Number of hours during week usually does physical activity


On those days, about how many hours does child usually do physical activity? hours

Skip: CPHY2B if (CPHY2!=1) Skip: CPHY2B if (CPHY1!=1)

CPHY2B Number of minutes during week usually does physical activity


On those days, about how many hours does child usually do physical activity? minutes

Skip: CPHY3 if (CPHY2!=1) Skip: CPHY3 if (CPHY1!=1)

CPHY5 How many days during school week usually does physical activity during school hours


On about how many days during the school week does child usually do physical activity during school hours? 1 Record days 2 None -> CPHY3 X Don't know -> CPHY3 R Refused -> CPHY3

CPHY5A Number of days during school week usually does physical activity during school hours


On about how many days during the school week does child usually do physical activity during school hours? [NOTE: THIS INCLUDES BEFORE AND AFTER SCHOOL SPORTS] days


CPHY6 How many hours during school week usually does physical activity during school hours


On those days, about how many hours does child usually do physical activity? 1 Record hours and minutes X Don't know -> CPHY3 R Refused -> CPHY3


CPHY6a How many hours during school week usually does physical activity during school hours


On those days, about how many hours does child usually do physical activity? hours

Skip: CPHY6B if (CPHY6!=1) Skip: CPHY6B if (CPHY5!=1)

CPHY6B Number of minutes during school week usually does physical activity during school hours


On those days, about how many hours does child usually do physical activity? minutes

Skip: CPHY3 if (CPHY6!=1) Skip: CPHY3 if (CPHY5!=1)


of 106


Question Code



CPHY3 How many days on weekend usually does physical activity


On about how many weekend days does child usually do physical activity? 1 Record days 2 None -> CPHY4A X Don't know -> CPHY4A R Refused -> CPHY4A

CPHY3A Number of days on weekend usually does physical activity


On about how many weekend days does child usually do physical activity? days


CPHY4 How many hours on weekend usually does physical activity


On a typical weekend day, about how many hours does child usually do physical activity? 1 Record hours and minutes 2 Does not do exercise on weekend -> CPIA9 X Don't know -> CPIA9 R Refused -> CPIA9


CPHY4A Number of hours on weekend usually does physical activity


On a typical weekend day, about how many hours does child usually do physical activity? hours

Skip: CPHY4B if (CPHY4!=1)

CPHY4B Number of minutes on weekend usually does physical activity


On a typical weekend day, about how many hours does child usually do physical activity? minutes

Skip: CPIA9 if (CPHY4!=1)

CPIA9 Recommended physical activity


How many minutes of physical activity is it recommended that children do each day? minutes 88888 Don't know 99999 Refused

CPIA1 How many days during week usually watch television/videos


On about how many days during the school week, does child usually watch TV, videos or DVDs at home? 1 Record days 2 None -> CPIA3 3 No TV/video in home -> CPIA3 X Don't know -> CPIA3 R Refused -> CPIA3

CPIA1A Number of days during week usually watch television/videos (coded)


On about how many days during the school week, does child usually watch TV, videos or DVDs at home? days

Skip: CPIA2 if (CPIA1!=1)


of 106


Question Code



CPIA2 How many hours during week usually watch television/videos (coded)


On those days, about how many hours does he/she usually spend watching TV, videos or DVDs? That is, how many hours on a typical weekday when TV is watched? 1 Record hours AND minutes X Don't know -> CPIA3 R Refused -> CPIA3

Skip: CPIA2A if (CPIA1!=1)

CPIA2A Number of hours during week usually watch television/videos


On those days, about how many hours does child usually spend watching TV, videos or DVDs? That is, how many hours on a typical weekday when TV is watched? hours

Skip: CPIA3 if (CPIA1!=1) Skip: CPIA3 if (CPIA2!=1)

CPIA2B Number of minutes during week usually watch television/videos


On those days, about how many hours does he/she usually spend watching TV, videos or DVDs? That is, how many hours on a typical weekday when TV is watched? minutes


CPIA3 How many days during weekend usually watch television/videos (coded)


On about how many weekend days does child usually watch TV, videos or DVDs at home? 1 Record Days 2 None -> CPIA5 3 No TV/video in home -> CPIA5 X Don't know -> CPIA5 R Refusal -> CPIA5

CPIA3A Number of days during weekend usually watch television/videos


On about how many weekend days does child usually watch TV, videos or DVDs at home? days


CPIA4 How many hours during weekend usually watch television/videos (coded)


On a typical weekend day, about how many hours does he/she usually spend watching TV, videos or DVDs? 1 Record in hours AND minutes X Don't know -> CPIA5 R Refused -> CPIA5


CPIA4A Number of hours during weekend usually watch television/videos


On a typical weekend day, about how many hours does he/she usually spend watching TV, videos or DVDs? hours


CPIA4B Number of minutes during weekend usually watch television/videos


On a typical weekend day, about how many hours does he/she usually spend watching TV, videos or DVDs? minutes



of 106


Question Code



CPIA5 How many days during week usually play video or computer games


On about how many days during the school week does child usually play video or computer games? 1 Record Days 2 None -> CPIA7 3 No video/computer games -> CPIA7 X Don't know -> CPIA7 R Refusal -> CPIA7

CPIA5A Number of days during week usually play video or computer games (coded)


On about how many days during the school week does child usually play video or computer games? Days


CPIA6 How many hours during week usually play video or computer games (coded)


On those days, about how many hours does he/she usually spend playing video or computer games? That is, how many hours on a typical weekday when video/computer games are played? 1 Record hours AND minutes X Don't know -> CPIA7 R Refused -> CPIA7


CPIA6A Number of hours during week usually play video or computer games


On those days, about how many hours does he/she usually spend playing video or computer games? That is, how many hours on a typical weekday when video/computer games are played? hours


CPIA6B Number of minutes during week usually play video or computer games


On those days, about how many hours does he/she usually spend playing video or computer games? That is, how many hours on a typical weekday when video/computer games are played? minutes


CPIA7 How many days during weekend usually play video or computer games (coded)


On about how many weekend days does child usually play video or computer games? 1 Record Days 2 None -> CPIA10 3 No video/computer games -> CPIA10 X Don't know -> CPIA10 R Refused -> CPIA10

CPIA7A Number of days during weekend usually play video or computer games


On about how many weekend days does child usually play video or computer games? days



of 106


Question Code



CPIA8 How many hours during weekend usually play video or computer games (coded)


On a typical weekend day, about how many hours does he/she usually spend playing video or computer games? 1 Record hours AND minutes X Don't know -> CPIA10 R Refused -> CPIA10


CPIA8A Number of hours during weekend usually play video or computer games


On a typical weekend day, about how many hours does he/she usually spend playing video or computer games? hours


CPIA8B Number of minutes during weekend usually play video or computer games


On a typical weekend day, about how many hours does he/she usually spend playing video or computer games? minutes


CPIA10 Recommended television watching


Up to how many hours of television, video, DVD or computer games is it recommended that children watch each day? hours 88888 Don't know 99999 Refused

Pff5 Limits on TV or Electronic Games


How often do you set limits on the amount of time child watches television or plays electronic games? [READ OUT] 1 Usually 2 Sometimes 3 Never X Don't know R Refused

CPINTX End of physical activity 3 child activity and inactivity (skip only)


SMKZ Start of smoking 1 prevalence (skip only)

Existing Adult

SMK Introduction to tobacco smoking (script only)

Existing Adult The following questions are about tobacco smoking. This includes cigarettes, cigars and pipes. [KEY "N" TO CONTINUE]


of 106


Question Code



SMK1 Personal smoking status

Existing Adult Which of the following best describes your smoking status? [READ OUT] 1 I smoke daily 2 I smoke occasionally 3 I don't smoke now, but I used to 4 I've tried it a few times but never smoked regularly 5 I've never smoked X Don't know R Refused

Skip: SMKX if (CHILD=1)

SMKX End of smoking 1 prevalence (skip only)

Existing Adult

CANZ Start of cannabis (skip only)

Existing Adult Skip: CANX if (AGE<16)

CANIN Introduction to cannabis (script only)

Existing Adult The following questions are about marijuana or hashish. [KEY "N" TO CONTINUE]

CAN1 Cannabis smoking status

Existing Adult Which of the following best describes your marijuana or hashish smoking status? [READ OUT] 1 I smoke daily 2 I smoke occasionally 3 I don't smoke now, but I used to 4 I've tried it a few times but never smoked regularly 5 I've never smoked X Don't know R Refused

CANX End of cannabis (skip only)

Existing Adult

SMKEZ Start of environmental tobacco smoke (skip only)


Child Skip: SMKEX if (CHILD=2) Skip: SMKEX if (PROXY=1)

SMK2 Home smoking status


Child Which of the following best describes your home situation? [READ OUT] 1 My home is smoke free (includes smoking is allowed outside only) 2 People occasionally smoke in the house 3 People frequently smoke in the house X Don't know R Refused


of 106


Question Code



SMK16 Car smoking status


Child Are people allowed to smoke in your car? 1 Yes 2 No 3 Don't have a car X Don't know R Refused

SMKEX End of environmental tobacco smoke (skip only)


Child

TOBACZ Start of tobacco 1 (regulations) (skip only)


Adult Skip: TOBACX if (CHILD=1)

TOBACC Introduction to Smoking Bans


Adult The new tobacco laws in NSW include smoking bans in a number of outdoor public places. [KEY N TO CONTINUE]

TOBAC1 Smoking ban within 10 metres of children's play equipment


Adult Do you support smoking being banned within 10 metres of children's play equipment? 1 Yes 2 No X Don't know R Refused

TOBAC2 Smoking ban at swimming pool complexes


Adult Do you support smoking being banned in public swimming pool complexes? 1 Yes 2 No X Don't know R Refused

TOBAC3 Smoking ban at spectator areas on sports grounds


Adult Do you support smoking being banned in spectator areas of sports grounds? 1 Yes 2 No X Don't know R Refused


of 106


Question Code



TOBAC4 Smoking ban at railway stations, bus stops, taxi ranks and ferry wharves


Adult Do you support smoking being banned at public transport stops and stations? [IF NECESSARY: This includes railway platforms, light rail stops, light rail stations, bus stops, taxi ranks, and ferry wharves] 1 Yes 2 No X Don't know R Refused

TOBAC5 Smoking ban within 4 metres of an access point to a public building


Adult Do you support smoking being banned within 4 metres of a pedestrian access point to a public building? 1 Yes 2 No X Don't know R Refused

TOBACX End of tobacco 1 (regulations) (skip only)


Adult

CHCZ Start of childcare, school attendance and reading to child (skip only)


Skip: CHCX if (CHILD=2) Skip: SC3 if (AGE>5) Skip: CHCX if (PROXY=1)

CHC Introduction to playgroups, childcare and school attendance (script only)


Now I just have a few questions about playgroups and childcare. [KEY "N" TO CONTINUE]

CAQ1 Ever attended organised early childhood program or activity


Has child ever attended any play group or other early childhood programme or activity? Please do not include child care programmes or time spent in preschool. 1 Yes 2 No -> CHC1 X Don't know -> CHC1 R Refused -> CHC1


of 106


Question Code



CAQ2 Currently attends other organised early childhood programs or activities


Does child currently attend any play group or other early childhood programme or activity? Please do not include child care programmes or time spent in preschool. 1 Yes 2 No X Don't know R Refused

Skip: CHC1 if (CAQ1!=1)

CHC1 Ever attended regular child care


Have you ever used any child care for child on a regular basis? [PROMPT; Regular basis means at least half a day a week] 1 Yes 2 No -> SC1 X Don't know -> SC1 R Refused -> SC1

CHC3 How old when first started childcare


How old was child when he/she first started childcare for half a day or longer 1 Record in years and months X Don't know -> CHC2 R Refused -> CHC2

Skip: CHC3b if (CHC1!=1)

CHC3b Age when first started childcare years


How old was child when he/she first started childcare for half a day or longer? years

Skip: CHC3c if (CHC1!=1) Skip: CHC3c if (CHC3=X) Skip: CHC3c if (CHC3=R)

CHC3c Age when first started childcare months


How old was child when he/she first started childcare for half a day or longer? months

Skip: CHC2 if (CHC1!=1) Skip: CHC2 if (CHC3=X) Skip: CHC2 if (CHC3=R)

CHC2 Currently attends childcare


Is child currently having any type of childcare on a regular basis? 1 Yes 2 No -> SC1 X Don't know -> SC1 R Refused -> SC1

Skip: CHC5 if (CHC1!=1)


of 106


Question Code



CHC5 Type of childcare


What type of childcare does child have? [MULTIPLE RESPONSE] Long day care centre Occasional Care Friend Grandparent Nanny Babysitter Relative or family OTHER THAN GRANDPARENT Family day care (usually organised through local councils) Other (Specify) Don't know Refused

Skip: SC1 if (CHC1!=1) Skip: SC1 if (CHC2!=1)

SC1 Preschool/school attendance


Does child go to preschool or attend a childcare that has a preschool programme? 1 Yes 2 No 3 Already started school X Don't know R Refused

Skip: SC3 if (AGE<2) Skip: SC3 if (AGE>4)

SC3 Type of school currently attending


What type of school does child currently attend? [READ OPTIONS 1-6: SINGLE RESPONSE] 1 Public school 2 Catholic school 3 Independent school (Private, NOT Catholic) 4 Special education school 5 School of the Air 6 Any other school [SPECIFY] X Don't know R Refusal

Skip: CHCX if (AGE<5) Skip: CHCX if (CHILD=2) Skip: CHCX if (PROXY=1)

CHCX End of playgroups, childcare and school attendance (skip only)


BOOZ Start of book reading to child (skip only)


Skip: BOOX if (CHILD=2) Skip: BOOX if (PROXY=1) Skip: BOOX if (CHILD=1)&(AGE>5)


of 106


Question Code



BOO Introduction to book reading (script only)


The next few questions are about reading. [KEY "N" TO CONTINUE]

Skip: BOOK if (CHILD=1)&(AGE>5) Skip: BOOK if (LOTE!=1) Skip: BOOK if (PROXY=1)

BOOK Read or look at books with child


Do you or other members of your family read or look at books with child? 1 Yes 2 No -> BOOX X Don't know -> BOOX R Refused -> BOOX

Skip: BKOF if (CHILD=1)&(AGE>5) Skip: BKOF if (LOTE!=1) Skip: BKOF if (PROXY=1)

BKOF How often read or look at books with child


In a typical week, how often do you or other members of your family read or look at books with child? 1 Every Day 2 At least once a week 3 At least once a month 4 Rarely X Don't know R Refused

Skip: BKAG if (CHILD=1)&(AGE>5) Skip: BKAG if (LOTE!=1) Skip: BKAG if (BOOK=2) Skip: BKAG if (BOOK=X) Skip: BKAG if (BOOK=R) Skip: BKAG if (PROXY=1)

BKAG Age of child being read to


How old was child when you or another member of your family started reading to him/her? 1 Less than 6 months 2 6 months-1 year 3 1-2 years 4 2-3 years 5 3 years and over X Don't know R Refused

Skip: BOOX if (CHILD=1)&(AGE>5) Skip: BOOX if (BOOK=2) Skip: BOOX if (BOOK=X) Skip: BOOX if (BOOK=R) Skip: BOOX if (PROXY=1)

BOOX End of book reading to child (skip only)


DEMAZ Start of concluding demographics (script only)

Existing All Now we are coming to the last section of the survey. I am going to ask some routine questions about your/child's background. Remember that all your answers remain confidential. [IF ASKED] We ask these questions so that we can get an idea of the health concerns of different groups of people such as men and women, city people and country people. [KEY "N" TO CONTINUE]


of 106


Question Code



INT1am Number of people living in the household (mobile frame)

Existing Adult (mobile only)

Can you please tell me, how many people, including yourself, live in your household? [INT NOTE: Knowing the number of householders is vital to providing accurate data] number of people in household 88888 Don't know 99999 Refused

Skip: INT1fm if (MOBILE=2)

INT1fm Number of children in the household (mobile frame)


And how many of the people living in the household are children under 16 years of age? [INT NOTE: Knowing the number of householders under 16 is vital to providing accurate data] number of people under 16 in household 88888 Don't know 99999 Refused

Skip: INT1dm if (INT1am=1) Skip: INT1dm if (MOBILE=2)

INT1dm Number of children aged 0-5 in the household (mobile frame)


Can you please tell me, of these, how many are under 6 years of age? [INT NOTE: Knowing the number of householders under 6 is vital to providing accurate data] number of people under 6 in household 88888 Don't know 99999 Refused

Skip: RLHP if (INT1am=1) Skip: RLHP if (INT1fm<1) Skip: RLHP if (MOBILE=2)


of 106


Question Code



RLHP Household structure

Existing All Besides yourself, who else do you/does child live with in your household [MULTIPLE RESPONSE] No one (lives alone) Mother Father Respondent's partner [PROBE FOR RELATIONSHIP TO CHILD] Step-mother Step-father Grandparents Son(s)/Daughter(s) Brothers and sisters Step brothers/sisters Other relatives Non-family members No one else besides respondent Other [SPECIFY] Don't know Refused

INT1e Number of residents aged 65+

Existing All Can you please tell me, how many people aged 65 years or over, live in your household.

Skip: MSTP if (INT1a=1)&(MOBILE=2) Skip: MSTP if (INT1am=1)&(MOBILE=1)

MSTP Formal marital status

Existing All What is your current formal marital status? Are you... (READ OPTIONS 1-5) 1 Married (this refers to registered marriages) 2 Widowed 3 Separated but not divorced 4 Divorced 5 Never married X Don't know R Refused

BPLPa Respondent Country of birth

Existing All In which country were you/was child born? 1 Australia -> BPMP 2 Other [SPECIFY] X Don't know -> BPMP R Refused -> BPMP

BPLPa1 Respondent's country of birth (coded)

Existing All In which country were you/was child born? Skip: BPMP if (BPLPa=1) Skip: BPMP if (BPLPa=R) Skip: BPMP if (BPLPa=X)


of 106


Question Code



BPMP Mother's country of birth

Existing All In which country was your mother born/was child's natural mother born? 1 Australia -> BPFP 2 Other [SPECIFY] X Don't know -> BPFP R Refused -> BPFP

BPMP1 Mother's country of birth (coded)

Existing All In which country was your mother born/was child's natural mother born?

Skip: BPFP if (BPMP!=2)

BPFP Fathers country of birth

Existing All In which country was your father born/was child's natural father born? 1 Australia -> LANPa 2 Other [SPECIFY] X Don't know -> LANPa R Refused -> LANPa

BPFP1 Fathers country of birth (coded)

Existing All In which country was your father born/was child's natural father born?

Skip: LANPa if (BPFP!=2)

LANPa Speak a language other than English at home

Existing All Do you usually speak a language other than English at home? [SINGLE RESPONSE] 1 Yes 2 No -> INGP X Don't know -> INGP R Refused -> INGP

Skip: LANPa1 if (LOTE!=1)

LANPa1 Language spoken at home (coded)

Existing All What language do you usually speak at home? Skip: INGP if (LOTE!=1) Skip: INGP if (LANPa!=1) Skip: INGP if (LOTE=2) Skip: INGP if (LOTE=3) Skip: INGP if (LOTE=4) Skip: INGP if (LOTE=5) Skip: INGP if (LOTE=6)

INGP Aboriginal or Torres Strait origin

Existing All Are you/Is child of Aboriginal or Torres Strait Islander origin? 1 Aboriginal but not Torres Strait Islander 2 Torres Strait Islander but not Aboriginal origin 3 Aboriginal and Torres Strait Islander origin 4 Not Aboriginal or Torres Strait Islander origin X Don't know R Refused -> QALLP


of 106


Question Code



INGP1 Other people in household of Aboriginal or Torres Strait Islander origin

Existing All Apart from yourself/child are there any other people in your household of Aboriginal or Torres Strait Islander origin? 1 Yes 2 No X Don't know R Refused

Skip: QALLP if (INGP=R) Skip: QALLP if (INT1a=1)&(MOBILE=2) Skip: QALLP if (INT1am=1)&(MOBILE=1)

QALLP Highest qualification completed

Existing Adult What is the level of the highest qualification you have completed? 1 Completed School Certificate/ Intermediate/ Year 10/4th Form.... 2 Completed HSC/Leaving/Year 12/ 6th Form 3 TAFE Certificate or Diploma 4 University, CAE or some other tertiary institute degree or higher 5 Other [SPECIFY] 6 Completed primary school 7 Completed years 7-9 X Don't know R Refused

Skip: QALLm if (CHILD=1)

QALLm Mother's highest qualification completed

Existing Child What is the level of the highest qualification child's mother has completed? 1 Completed School Certificate/ Intermediate/ Year 10/4th Form.... 2 Completed HSC/Leaving/Year 12/ 6th Form 3 TAFE Certificate or Diploma 4 University, CAE or some other tertiary institute degree or higher 5 Other [SPECIFY] 6 Completed primary school 7 Completed years 7-9 X Don't know R Refused

Skip: QALLf if (MOTHER=3) Skip: QALLf if (CHILD=2) Skip: QALLf if (PROXY=1)


of 106


Question Code



QALLf Fathers highest qualification completed

Existing Child What is the level of the highest qualification child's father has completed? 1 Completed School Certificate/ Intermediate/ Year 10/4th Form.... 2 Completed HSC/Leaving/Year 12/ 6th Form 3 TAFE Certificate or Diploma 4 University, CAE or some other tertiary institute degree or higher 5 Other [SPECIFY] 6 Completed primary school 7 Completed years 7-9 X Don't know R Refused

Skip: LFSP if (FATHER=3) Skip: LFSP if (CHILD=2) Skip: LFSP if (PROXY=1)

LFSP Current employment status

Existing All In the last week, which of the following best describes your employment status? [READ OUT] 1 A salary or wage earner or conducting a business -> HRSP 2 A salary or wage earner or conducting a business but absent on paid leave (including unpaid maternity, holidays, on strike/stood down) 3 Unpaid work in a family business -> HRSP 4 Other unpaid work 5 Did not have a job X Don't know/Not sure R Refused

Skip: LFS if (CHILD=1)

LFS Actively looking for work

Existing Adult Were you actively looking for work in the last week? 1 Yes - Looked for Full-time work 2 Yes - Looked for Part-time work 3 No - Did not look for work X Don't know R Refused

Skip: HRSP if (CHILD=1) Skip: HRSP if (LFSP=1) Skip: HRSP if (LFSP=2) Skip: HRSP if (LFSP=3)

HRSP Number of hours worked in last week

Existing Adult In the last week, how many hours did you work in all jobs? No. of hours 888 Don't know 999 Refused

Skip: MTWP2 if (CHILD=1) Skip: MTWP2 if (LFS!=0)


of 106


Question Code



MTWP2 Usual transport to work

Existing All How do you/does child usually get to work/school? [MULTIPLE RESPONSE] Train Bus Ferry Tram (including light rail) Taxi Car - as driver Car - as passenger Truck Motorbike or motor scooter Bicycle Walk only Work at home Walk part of the way Other Don't know Refused

Skip: LFSPm if (LFS!=0) Skip: LFSPm if (AGE<5)

LFSPm Mother's employment status

Existing Child In the last week, which of the following best describes the employment status of child's mother [READ OUT] 1 A salary or wage earner or conducting a business -> HRSP 2 A salary or wage earner or conducting a business but absent on paid leave (including unpaid maternity, holidays, on strike/stood down) 3 Unpaid work in a family business -> HRSP 4 Other unpaid work 5 Did not have a job X Don't know/Not sure R Refused

Skip: LFSm if (MOTHER=3) Skip: LFSm if (CHILD!=1)

LFSm Mother actively looking for work

Existing Child Was child's mother actively looking for work in the last week? 1 Yes - Looked for Full-time work 2 Yes - Looked for Part-time work 3 No - Did not look for work X Don't know R Refused

Skip: LFSPf if (CHILD!=1) Skip: LFSPf if (MOTHER=3) Skip: LFSPf if (LFSPm=1) Skip: LFSPf if (LFSPm=2) Skip: LFSPf if (LFSPm=3)


of 106


Question Code



LFSPf Father's employment status

Existing Child In the last week, which of the following best describes the employment status of child's father? [READ OUT] 1 A salary or wage earner or conducting a business -> HRSP 2 A salary or wage earner or conducting a business but absent on paid leave (including unpaid maternity, holidays, on strike/stood down) 3 Unpaid work in a family business -> HRSP 4 Other unpaid work 5 Did not have a job X Don't know/Not sure R Refused

Skip: LFSf if (CHILD!=1) Skip: LFSf if (FATHER=3)

LFSf Father actively looking for work

Existing Child Was child's father actively looking for work in the last week? 1 Yes - Looked for Full-time work 2 Yes - Looked for Part-time work 3 No - Did not look for work X Don't know R Refused

Skip: DEM11 if (CHILD=2) Skip: DEM11 if (LFSPf=1) Skip: DEM11 if (LFSPf=2) Skip: DEM11 if (LFSPf=3) Skip: DEM11 if (CHILD!=1) Skip: DEM11 if (FATHER=3)

DEM11 Currently receive a pension or benefit

Existing Adult 65+

Do you currently receive a government pension, allowance or benefit? [ANY GOVT. ALLOWANCE, PENSION OR BENEFIT] 1 Yes 2 No X Don't know R Refused

Skip: DEM13 if (AGE<65)

DEM13 Private health insurance status

Existing All Apart from Medicare, are you/is child currently covered by private health insurance? 1 Yes 2 No X Don't know R Refused


of 106


Question Code



INC2 Household income

Existing All I would now like to ask you about your HOUSEHOLD'S income. What is your annual HOUSEHOLD income before tax? Would it be: [READ OUT] 2 less than $20,000 3 $20,000-$40,000 4 $40,000-$60,000 5 $60,000-$80,000 6 More than $80,000 X Don't know R Refused

DEM16 Postcode Existing All Could you please tell me your postcode? postcode 88888 Don't know 99999 Refused

DEM17 Suburb/Town (no code)

Existing All What is the name of the suburb or town where you live [CHECK SPELLING IF UNSURE!!!]

DEM18a Local Government Area (LGA)

Existing All What is the name of your local Council or Shire? [CHECK SPELLING IF UNSURE!!!] 1 A-F 2 G-O -> DEM18e 3 P-Y -> DEM18d X Don't know -> DEM20 R Refused -> DEM20

DEM18b Local Government Area (LGA)

Existing All What is the name of your local Council or Shire? [CHECK SPELLING IF UNSURE!!!]

Skip: DEM18e if (DEM18a!=1)

DEM18e Local Government Area (LGA)


Skip: DEM18d if (DEM18a!=2)

DEM18d Local Government Area (LGA)


Skip: DEM20 if (DEM18a!=3)

DEM20 Number of residential telephone numbers

Existing All How many residential telephone numbers do you have? Do not include mobile phone numbers or dedicated FAX numbers or modems. residential phone numbers 88888 Don't know 99999 Refused


of 106


Question Code



DEM20a White pages listing of these landline numbers

Existing All Is this/are these landline number/s listed in the white pages? 1 Yes 2 No X Don't know R Refused

Skip: DEM20b if (DEM20=0)

DEM20b Number of mobile phone numbers personally have

Existing All How many mobile phone numbers do you personally have? Do not include business mobile phone numbers. mobile phone numbers 88888 Don't know 99999 Refused

Skip: DEM20a if ((DEM20b>10)&(DEM20b<88888)|(DEM20b>88888)&(DEM20b<99999))

DEM20c White pages listing of these mobile numbers

Existing All Is this/are these mobile number listed in the white pages? 1 Yes 2 No X Don't know R Refused

Skip: CMOBG if (DEM20b=0)

CMOBG Agree to be contacted for child health survey

Existing (mobile frame: any child; landline frame child<6)

Adult As we also conduct a child health survey, would you or the main carer of your agree to complete an interview about your in the future? The survey would take about 20 to 25 minutes. [NOTE: if respondent denies children in household select Refused] 1 Yes - and main carer 2 Yes - but not main carer 3 No -> PREREC X Don't know -> PREREC R Refused -> PREREC

Skip: PREREC if (RLHP8!=1) Skip: PREREC if (MOBILE=2)&(INT1a=1) Skip: PREREC if (MOBILE=2)&(INT1f=0) Skip: PREREC if (MOBILE=2)&(INT1d=0) Skip: PREREC if (MOBILE=1)&(INT1am=1) Skip: PREREC if (MOBILE=1)&(INT1fm=0) Skip: PREREC if (PROXY=1) Skip: PREREC if (CHILD=1)

CMOBG1 Main carer name for child health survey


Adult Could you please reconfirm your name/give me the name of the main carer Name:

Skip: CMOBG2 if (CMOBG=3) Skip: CMOBG2 if (CMOBG=X) Skip: CMOBG2 if (CMOBG=R)


of 106


Question Code



CMOBG2 Main carer contact number for child health survey


Adult Could you please confirm your best contact number/ give me the best contact number of the main carer [INTERVIEWER NOTE: include 02 in NSW landline numbers] PHONE NUMBER:

Skip: PREREC if (CMOBG=3) Skip: PREREC if (CMOBG=X) Skip: PREREC if (CMOBG=R)

PREREC Calculation of mobile phone status of household (skip only)

Existing All

REC1 Agree to be contacted for validation

Existing All As part of our quality control procedures our supervisors call back roughly 10% of respondents to check 3 or 4 questions. It would take no more than 1 minute of your time. Would you be willing to be called back? 1 Yes 2 No -> THANKS X Don't know -> THANKS R Refused -> THANKS

THANKS (no code) Existing All That completes the survey. Thank you for taking the time to help us. The information will be used to help improve health services in your local area and across the state. Do you have any further comments?

DEM7 LOTE at home for those not completing survey in English

Existing All Can you please tell me which language you speak as your first language? [PLEASE PROBE]

LANG (script only) Existing All We will be interviewing people in your language. One of our bilingual interviewers will call you in about a month to do the interview with you. [KEY "N" TO CONTINUE]

Skip: TGB if (DEM7!=7)&(DEM7!=8)&(DEM7!=26)&(DEM7!=36)&(DEM7!=19)&(DEM7!=58)&(DEM7!=32)&(DEM7!=1)

TGB (no code) Existing All

END Existing All

Please see below for key


of 106


Child:

CHILD = 1, the survey subject is a child

CHILD = 2, the survey subject is an adult

CHILD = 0, proxy

Proxy:

PROXY = 0, adult or child

PROXY = 1, Interviewing on behalf of another adult

Age:

The survey subject’s age in years

Mobile:

Mobile = 1, mobile phone number

Mobile = 2, landline phone number

Parents:

Mother = 1, mother

Mother = 2, step-mother

Mother = 3, grand-mother

Father = 1, mother

Father = 2, step-father

Father = 3, grandfather


of 106

nsw population health survey 2013 - questionnaire · 2018. 8. 31. · nsw population health survey...

Documents