About how many hours did the [age] year old child watch television yesterday?

About how many hours per week does the [age] year old child spend in a day care center, day care home, or pre-school?

Are there family rules about:
a. What time the [age] year old child goes to bed on a school night?
b. T he amount of time the [age] year old child is allowed to watch television?
c. Which television programs and movies the [age] year old child is allowed to watch?
d. Which computer or video games the [age] year old child is allowed to play?

Are you a parent or a guardian of this child?

Is the [age] year old child’s time divided between parents or guardians who live in separate households?

On how many days out of the past seven days was the [age] year old child supervised by an adult after school?

To the following questions please answer how many days during the past seven days you have done the following activities with the [age] year old child.
A. Played a sport, physical game, or exercised with the [age] year old child?
b. Played a non-physical game with the [age] year old child?
c. Watched television with the [age] year old child?
d. Read to the [age] year old child?

To the following questions please answer how many days out of the past seven days you did the following activities with the [age] year old child?
a. Played a sport, physical game, or exercised together with the [age] year old child?
b. Played a non-physical game with the [age] year old child?
c. Watched television with the [age] year old child?
d. Spent at least 20 minutes talking with the [age] year old child?
e. Helped the [age] year old child with school activities or homework?
f. Made the [age] year old child responsible for completing a household chore?
g. Attended a game or event the [age] year old child participated in?

What is the age of the oldest child in your household under the age of 18?

Where does the [age] year old child go most often when school lets out?

Would you say you are the parent or guardian who spends the most time caring for the [age] year old child?

About how much do you think you weighed when you were 21 years old?

During the past seven days, how many days did you do any activities that increase muscle strength or tone, such as lifting weights, pull-ups, push-ups, or sit-ups?

During the past seven days, how many days did you do moderate activities for at least ten minutes, such as brisk walking, bicycling, gardening, or anything else that caused some increase in breathing or heart rate?

During the past seven days, how many days did you do vigorous activities for at least ten minutes, such as running, aerobics, heavy yard work, or anything else that caused large increases in breathing or heart rate?

During the past seven days, how many hours did you spend using a computer during your leisure-time?

During the past seven days, how many hours did you spend watching television while sitting or lying down?

During the past seven days, how many days did you walk continuously for at least ten minutes for recreation, exercise, or to get to and from places?

Has a doctor or other health professional ever talked to you about physical activity or exercise?

How many days per week do you do these moderate activities for at least 10 minutes at a time?

How many days per week do you do these vigorous activities for at least 10 minutes at a time?

How many hours per week do you work at a job or business?

Now, thinking about the moderate physical activities you do [fill in (when you are not working) if "employed" or "self-employed" to core Q13.8] in a usual week, do you do moderate activities for at least 10 minutes at a time, such as brisk walking, bicycling, vacuuming, gardening, or anything else that causes small increases in breathing or heart rate?

Now thinking about the vigorous physical activities you do [fill in (when you are not working) if "employed" or "self-employed" to core Q12.8 or Q13.8] in a usual week, do you do vigorous activities for at least 10 minutes at a time, such as running, aerobics, heavy yard work, or anything else that causes large increases in breathing or heart rate?

On days when you did moderate activities, how much total time did you spend doing these activities?

On days when you did vigorous activities, how much total time did you spend doing these activities?

On days when you do moderate activities for at least 10 minutes at a time, how much total time per day do you spend doing these activities?

On days when you do vigorous activities for at least 10 minutes at a time, how much total time per day do you spend doing these activities?

How much has your weight changed over the past five years?

On days when you walked, how much total time did you spend walking?

What kind of business or industry is this? (What was made, sold, or service provided)

What kind of work do you do now?

When you are at work, which of the following best describes what you do?
Would you say:

• Mostly sitting or standing
• Mostly walking
• Mostly heavy labor or physically demanding work

When you are at work, which of the following best describes what you do? [NOTE: If respondent has multiple jobs, include all jobs.]
Would you say:

• Mostly sitting or standing
• Mostly walking
• Mostly heavy labor or physically demanding work

Which of the following best describes your future plans regarding physical activity?

The next two questions are about physical activity that you may do as part of your daily transportation to your job, the store, or other places that you go. Please include physical activity that you may have included in your previous answers.

During the past month, did you ride a bicycle for transportation, like to go to or from work, to run errands, or to go somewhere else that you wanted or needed to go?

The next two questions are about physical activity that you may do as part of your daily transportation to your job, the store, or other places that you go. Please include physical activity that you may have included in your previous answers.

During the past month, did you walk for transportation, like to go to or from work, to run errands, or to go somewhere else that you wanted or needed to go?

About how long has this doctor been caring for you?

About how old do you think your doctor is?

Are you able to see the same doctor every time or nearly every time you have a routine check-up or care for a medical condition?

During the past two years, was there a time that you thought you needed to see a specialist but were unable to get a referral?

How would you rate your doctor’s medical skill?

Other than vitamins or antibiotics, do you take any medication that is prescribed by your doctor on a daily basis for control of a medical problem?

What is the medical specialty of your doctor?

What is the sex of your doctor?

Who decides when you need your next appointment?

During the past ten years have you received a tetanus shot?

Is there one particular doctor or health professional who you usually go to when you need routine medical care?

Have you been pregnant in the last 5 years?

To your knowledge, are you now pregnant?

(Has a doctor or other health professional) ever advised you to quit smoking?

(Has a doctor or other health professional ever talked with you) about alcohol use?

(Has a doctor or other health professional ever talked with you) about drug abuse?

Has a doctor or other health professional ever talked with you about getting a mammogram?

(Has a doctor or other health professional ever talked with you) about injury prevention, such as safety belt use, helmet use, or smoke detectors?

Has a doctor or other health professional ever talked with you about physical activity or exercise?

(Has a doctor or other health professional) ever talked with you about your sexual practices, including family planning, sexually transmitted diseases, AIDS, or the use of condoms?

Has a doctor or other health professional ever talked with you about your diet or eating habits?

A digital rectal exam is an exam in which a doctor, nurse, or other health professional places a gloved finger into the rectum to feel the size, shape, and hardness of the prostate gland. Have you ever had a digital rectal exam?

A Prostate-Specific Antigen test, also called a PSA test, is a blood test used to check men for prostate cancer. Have you ever had a PSA test?

Has your father, brother, son, or grandfather ever been told by a doctor, nurse, or health professional that he had prostate cancer?

Have you ever been told by a doctor, nurse, or other health professional that you had prostate cancer?

How long has it been since you had your last PSA test?

How long has it been since your last digital rectal exam?

Previously, I asked you some questions about tests for prostate cancer you may have had. Has you physician ever discussed with you both the advantages and disadvantages of being screened for prostate cancer?

When did you have your last digital rectal exam?

When did you have your last PSA test?

How do you feel about laws that require drivers and front seat passengers to wear seat belts? Do you favor these laws a lot, do you favor them some or do you favor these laws not at all?

Do you think that seat belt laws should also apply to back seat adult passengers?

In your opinion, SHOULD police be allowed to stop a vehicle if they observe a seat belt violation when no other traffic laws are being broken?

In some schools, students have their heights and weights measured to determine their level of growth and development, and to identify children who may be overweight or underweight for their age. Do you favor this practice in Kansas schools?