Seatbelts
c = CDC Core Question, o = CDC Optional Question, s = State-Added Question
During the past 30 days, how often did the [randomly selected child] ride in the back seat?
2001sfor During the past 30 days, how often did the [randomly selected child] ride in the back seat?
 
During the past 30 days, how often did the [randomly selected child] use a child safety seat, booster seat, or seat belt when riding in a car, van, sports utility vehicle, or truck?
2001sfor During the past 30 days, how often did the [randomly selected child] use a child safety seat, booster seat, or seat belt when riding in a car, van, sports utility vehicle, or truck?
 
During that time, did the [randomly selected child] use: a child safety seat?
2001sfor During that time, did the [randomly selected child] use: a child safety seat?
 
(During that time, did the [randomly selected child] use): a booster seat?
2001sfor (During that time, did the [randomly selected child] use): a booster seat?
 
(During that time, did the [randomly selected child] use): a seat belt only?
2001sfor (During that time, did the [randomly selected child] use): a seat belt only?
 
(Has a doctor or other health professional ever talked with you) about drug abuse?
1996o, 2000sfor (Has a doctor or other health professional ever talked with you) about drug abuse?
 
How often do you use seatbelts when you drive or ride in a car?
1992c, 1993c, 1994o, 1995c, 1997c, 1999sfor How often do you use seatbelts when you drive or ride in a car?, 2002cfor How often do you use seatbelts when you drive or ride in a car?, 2005sfor How often do you use seatbelts when you drive or ride in a car?, 2006cfor How often do you use seatbelts when you drive or ride in a car?
 
How often does the [fill in age]-year-old child in your household use a... car safety seat [for child under 5] or seatbelt [for child 5 or older] ...when they ride in a car?
1995c, 1997c, 1999sfor How often does the [fill in age]-year-old child in your household use a... car safety seat [for child under 5] or seatbelt [for child 5 or older] ...when they ride in a car?
 
How often does the oldest child (of children under age 15) in your household use a... car safety seat [for child under 5] or seatbelt [for child 5 or older] ...when they ride in a car?
1993c, 1994o
 
Sexual Behavior
c = CDC Core Question, o = CDC Optional Question, s = State-Added Question
Are you or your [fill in (husband/partner)] using any kind of birth control now? Birth control means having your tubes tied, vasectomy, the pill, condoms, diaphragm, foam, rhythm, Norplant, shots (Depo-provera) or any other way to keep from getting pregnant.
1998o
 
Are you or your [fill in (wife/partner)] using any kind of birth control now? Birth control means having your tubes tied, vasectomy, the pill, condoms, diaphragm, foam, rhythm, Norplant, shots (Depo-provera) or any other way to keep from getting pregnant.
1998s
 
Are you or your [husband/wife/partner] doing anything now to keep [you/her] from getting pregnant? Some things people do to keep from getting pregnant include not having sex at certain times, using birth control methods such as the pill, Norplant, shots or Depo-provera, condoms, diaphragm, foam, IUD, having their tubes tied, or having a vasectomy.
2002cfor Are you or your [husband/wife/partner] doing anything now to keep [you/her] from getting pregnant?
 
During the past 12 months, with how many different people have you had sexual intercourse?
1997s
 
[Females] What is your main reason for not doing anything to keep from getting pregnant?
[Males]What is your main reason for not doing anything to keep your partner from getting pregnant? 
2002cfor [Females] What is your main reason for not doing anything to keep from getting pregnant?
 
(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?
1996o, 1999sfor (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?, 2000sfor (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?
 
How many new sex partners did you have during the past 12 months?
1997s, 1999sfor How many new sex partners did you have during the past 12 months?
 
I’m going to read you a list. When I’m done, please tell me if any of the situations apply to you. You don't need to tell me which one.
  • You have used injectable drugs in the past year.
  • You tested positive for having HIV, the virus that causes AIDS.
  • You had anal sex without a condom in the past year.
Do any of these situations apply to you?
1997s
 
In the past five years, have you been treated for a sexually transmitted or venereal disease?
1997s
 
Some things people do to keep from getting pregnant include not having sex at certain times, using birth control methods such as the pill, Norplant, shots or Depo-provera, condoms, diaphragm, foam, IUD, having their tubes tied, or having a vasectomy. Are you or your [husband/wife/partner] doing anything now to keep [you/her] from getting pregnant?
2004cfor Some things people do to keep from getting pregnant include not having sex at certain times, using birth control methods such as the pill, Norplant, shots or Depo-provera, condoms, diaphragm, foam, IUD, having their tubes tied, or having a vasectomy. Are you or your [husband/wife/partner] doing anything now to keep [you/her] from getting pregnant?
 
The last time you had sexual intercourse, was the condom used ..
  • To prevent pregnancy
  • To prevent diseases like syphilis, gonorrhea, and AIDS
  • For both of these reasons
  • For some other reason
1997s
 
Was a condom used the last time you had sexual intercourse?
1997s
 
Were you treated at a local health department?
1997s
 
What are you or your [if female husband/partner; if male, insert wife/partner] doing now to keep [if female, insert "you"; insert "her" if male] from getting pregnant?
2002cfor What are you or your [if female husband/partner; if male, insert wife/partner] doing now to keep [if female, insert "you"; insert "her" if male] from getting pregnant?, 2004cfor What are you or your [if female husband/partner; if male, insert wife/partner] doing now to keep [if female, insert "you"; insert "her" if male] from getting pregnant?
 
What are your reasons for not using any birth control now?
1998o
 
What kinds of birth control are you or your [fill in (husband/partner)] using now?
1998o
 
What kinds of birth control are you or your [fill in (wife/partner)] using now?
1998s
 
What is the main reason for not doing anything to keep [if female husband/partner; if male, insert wife/partner] from getting pregnant?
2004cfor What is the main reason for not doing anything to keep [if female husband/partner; if male, insert wife/partner] from getting pregnant?
 
What other method are you also using to prevent pregnancy?
2002cfor What other method are you also using to prevent pregnancy?
 
Skin Cancer
c = CDC Core Question, o = CDC Optional Question, s = State-Added Question
Have you ever been told by a doctor that you have skin cancer?
1997s
 
Have you had any of the following skin cancers?
  • Melanoma
  • Basal cell
  • Squamous cell
  • Some other type of skin cancer (specify: _____)
1997s
 
How long ago was your melanoma skin cancer diagnosed?
1997s
 
Including times when even a small part of your skin was red for more than 12 hours, how many sunburns have you had within the past 12 months?
1999cfor Including times when even a small part of your skin was red for more than 12 hours, how many sunburns have you had within the past 12 months?, 2004cfor Including times when even a small part of your skin was red for more than 12 hours, how many sunburns have you had within the past 12 months?
 
The next question is about sunburns, including any time that even a small part of your skin was red for more than 12 hours. Have you had a sunburn within the past 12 months?
1999cfor The next question is about sunburns, including any time that even a small part of your skin was red for more than 12 hours. Have you had a sunburn within the past 12 months?, 2004cfor The next question is about sunburns, including any time that even a small part of your skin was red for more than 12 hours. Have you had a sunburn within the past 12 months?
 
Have you ever had all of your skin from head to toe checked for cancer either by a dermatologist or some other kind of doctor?
[Interviewer note: If asked, 'A dermatologist is a doctor who specializes in skin diseases'.]
If 'Yes' probe for how long ago
2005sfor Have you ever had all of your skin from head to toe checked for cancer either by a dermatologist or some other kind of doctor?
 
When you go outside on a very sunny day, for more than one hour, how often do you stay in the shade?
2005sfor When you go outside on a very sunny day, for more than one hour, how often do you stay in the shade?
 
When you go outside on a very sunny day, for more than one hour, how often do you wear a hat that shades your face, ears, and neck?
[READ IF NECESSARY] Do not include visors, baseball caps, or hats that do not shade the ears and neck.
2005sfor When you go outside on a very sunny day, for more than one hour, how often do you wear a hat that shades your face, ears, and neck?
 
When you go outside on a very sunny day, for more than one hour, how often do you wear a long sleeved shirt?
2005sfor When you go outside on a very sunny day, for more than one hour, how often do you wear a long sleeved shirt?
 
When you go outside on a very sunny day, for more than one hour, how often do you use sunscreen?
2005sfor When you go outside on a very sunny day, for more than one hour, how often do you use sunscreen?
 
Have you used a sun lamp or tanning bed in the past 12 months?
2005sfor Have you used a sun lamp or tanning bed in the past 12 months?
 
Has a doctor, nurse, or other health professional ever advised or discussed with you about taking protective measures against skin cancer. Protective measures include use of sunscreen, protective clothing and avoiding exposure to sunlamps or tanning beds.
If 'Yes', probe for how long ago
2005sfor Has a doctor, nurse, or other health professional ever advised or discussed with you about taking protective measures against skin cancer. Protective measures include use of sunscreen, protective clothing and avoiding exposure to sunlamps or tanning beds.
 
Smoke Detectors
c = CDC Core Question, o = CDC Optional Question, s = State-Added Question
Do you have a functioning smoke detector on every level of your home and outside each sleeping area?
2002sfor Do you have a functioning smoke detector on every level of your home and outside each sleeping area?
 
Do you have a specific plan for how you would escape from your house or apartment in case of fire?
1993c
 
Does your family have an escape plan in case of fire in the home?
2002sfor Does your family have an escape plan in case of fire in the home?
 
(Has a doctor or other health professional ever talked with you) about injury prevention, such as safety belt use, helmet use, or smoke detectors?
1996o, 2000sfor (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 your family practiced an escape plan in case of fire in the home?
2002sfor Has your family practiced an escape plan in case of fire in the home?
 
Has your family practiced or discussed an escape plan in case of a fire at home?
1994o
 
Is there a working smoke detector in your household?
1994s
 
When was the last time you or someone else deliberately tested all of the smoke detectors in your home?
1999cfor When was the last time you or someone else deliberately tested all of the smoke detectors in your home?
 
When was the last time you or someone else deliberately tested all of the smoke detectors in your home, either by pressing the test buttons or holding a source of smoke near them?
1995c, 1997c
 
Which of the following best describes whether you have a smoke detector in your home? Is it:
  • I don't have a smoke detector.
  • I have an installed and working smoke detector.
  • I have a smoke detector, but it is not installed.
  • I have a smoke detector, but it is broken or the battery is missing.
  • I have a smoke detector, but don't know if it works.
1996s, 1999sfor Which of the following best describes whether you have a smoke detector in your home? Is it:, 2002sfor Which of the following best describes whether you have a smoke detector in your home? Is it:
 
Social Context
c = CDC Core Question, o = CDC Optional Question, s = State-Added Question
Do you rent or own your home?
1996s, 1997o
 
How long have you lived at your current address?
1996s, 1997o
 
How many close friends or relatives would help you with your emotional problems or feelings if you needed it?
1997o
 
How safe from crime do you consider your neighborhood to be?
1997o
 
In the past 30 days, have you been concerned about having enough food for you or your family?
1997o
 
What is the source of water you usually drink at home? Is it:
  • City/town water supple
  • Private well
  • Bottled water
  • Other
1996s
 
Excess Sun Exposure
c = CDC Core Question, o = CDC Optional Question, s = State-Added Question
Have you had a sunburn within the past 12 months?
2003cfor Have you had a sunburn within the past 12 months?
 
Including times when even a small part of your skin was red for more than 12 hours, how many sunburns have you had within the past 12 months?
2003cfor Including times when even a small part of your skin was red for more than 12 hours, how many sunburns have you had within the past 12 months?