Vaccines, Parental Attitudes About (see also Parental Attitudes About Vaccines)
c = CDC Core Question, o = CDC Optional Question, s = State-Added Question
CATI NOTE: If Core Section Children in Household = 88 (No children under age 18 in the household) or 99 (Refused), go to Next Module.

In general, how confident are you in the safety of routine childhood vaccines? Would you say...
  • Not at all confident
  • A little confident
  • Moderately confident
  • Very confident
 
What is your greatest concern about childhood vaccines, if any? Would you say...

Interviewer Probe: If they give more than one answer, please say: "Which ONE is your greatest concern?"
  • Too many vaccines are given
  • Vaccines are not safe
  • Vaccines cause diseases such as autism
  • Vaccines are not necessary
  • Vaccines cause short term side effects, such as fever and pain
  • I have no concerns about childhood vaccines
 
What is the most important source of information that has helped you make decisions about vaccinating your child? Would you say...
  • Healthcare provider
  • Media such as magazines, television, or radio
  • Internet
  • Friends or family
 
The next question is about the "Xth" [Fill in correct number] child.

Have you obtained ALL age appropriate immunizations or shots for [Fill him/her] as recommended by your child?s healthcare provider? Would you say...
  • Yes, all age appropriate
  • Yes, some age appropriate
  • No
  • Healthcare provider has not recommended any immunizations
  • Healthcare provider has specifically stated not to obtain any immunizations
 
Veteran's Health
c = CDC Core Question, o = CDC Optional Question, s = State-Added Question
Did you ever serve in a combat or war zone?
 
Has a doctor or other health professional ever told you that you have depression, anxiety, or post traumatic stress disorder (PTSD)?
 
A traumatic brain injury may result from a violent blow to the head or when an object pierces the skull and enters the brain tissue. Has a doctor or other health professional ever told you that you have suffered a traumatic brain injury (TBI)?
 
In the past 12 months, did you receive any psychological or psychiatric counseling or treatment?
 
Has there been a time in the past 12 months when you thought of taking your own life?
 
During the past 12 months, did you attempt to commit suicide?
 
Veterans' Health Status
c = CDC Core Question, o = CDC Optional Question, s = State-Added Question
Which of the following best describes your service in the United States military?
 
In the last 12 months, have you received some or all of your health care from VA hospital or clinic?
 
Since September 11, 2001, have you been deployed to the regions of Afghanistan or Iraq in support of U.S. military operations?

INTERVIEWER NOTE: This includes countries in the Middle East region such as Iraq, Saudi Arabia, Kuwait, the Persian Gulf, and other forward deployed operating areas such as the countries bordering Afghanistan.
 
Veteran's Status
c = CDC Core Question, o = CDC Optional Question, s = State-Added Question
In the last 12 months have you received some or all of your health care from VA facilities?
 
Have you ever served on active duty in the United States Armed Forces, either in the regular military or in a National Guard or military reserve unit? Active duty does not include training for the Reserves or National Guard, but DOES include activation, for example, for the Persian Gulf War.
 
The next question relates to military service in the United States Armed Forces, either in the regular military or in a National Guard or Reserve unit.

Have you ever served on active duty in the United States Armed Forces, either in the regular military or in a National Guard or military reserve unit?
 
Which of the following best describes your service in the United States military?
 
Violence and Crime
c = CDC Core Question, o = CDC Optional Question, s = State-Added Question
During the past year have you known or seen anyone who was beaten or otherwise hurt by their husband, wife, boyfriend, or girlfriend?
1996s
 
How afraid are you to leave your home at night? Would you say:
  • Very afraid
  • Somewhat afraid
  • A little afraid
  • Not afraid
1996s
 
When was the last time you saw a violent crime in your neighborhood (someone hurting or trying to hurt someone else)?
1996s
 
Vision Impairment
c = CDC Core Question, o = CDC Optional Question, s = State-Added Question
Are you blind or do you have serious difficulty seeing, even when wearing glasses?
 
Do you have any trouble seeing, even when wearing glasses or contact lenses?
 
Has a doctor, nurse or other health professional ever said that you have vision impairment in one or both eyes, even when wearing glasses?
 
Visual Impairment and Access to Eye Care
c = CDC Core Question, o = CDC Optional Question, s = State-Added Question
Now I would like to ask you questions about your vision. These questions are for all respondents regardless of whether or not you wear glasses or contact lenses. If you wear glasses or contact lenses, answer questions as if you are wearing them.

How much difficulty, if any, do you have in recognizing a friend across the street?
 
How much difficulty, if any, do you have reading print in newspapers, magazines, recipes, menus, or numbers on the telephone?
 
When was the last time you had your eyes examined by any doctor or eye care provider?
 
What is the main reason you have not visited an eye care professional in the past 12 months?
 
When was the last time you had an eye exam in which the pupils were dilated? This would have made you temporarily sensitive to bright light.
 
Do you have any kind of health insurance coverage for eye care?
 
Have you been told by an eye doctor or other health care professional that you NOW have cataracts?
 
Have you EVER been told by an eye doctor or other health care professional that you had glaucoma?
 
Age-related Macular Degeneration (AMD) is a disease that affects the macula, the part of the eye that allows you to see fine detail.

Have you EVER been told by an eye doctor or other health care professional that you had age-related macular degeneration?