Form 42 - OS Questionnaire

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Sara Alexander
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ID WHI Common ID Col#1 F42DAYS F42 Days since enrollment Col#2 0-1044 58-18.573 26.984 F42COT Contact type Col#3 The method used to collect the data. 1 Phone 481 0.5 2 Mail 27,350 29.

1 ID WHI Common ID Col#1 F42DAYS F42 Days since enrollment Col# F42COT Contact type Col#3 The method used to collect the data. 1 Phone Mail 27, Visit 64, Other 1, WGTBRTH Weight at birth Col#4 When you were born, about how much did you weigh? (Give your best guess.) 1 Less than 6 pounds 9, pounds to 7 pounds 15 ounces 53, pounds to 9 pounds 15 ounces 15, or more pounds 2, Don't know 11, FULLTERM Full term or premature Col#5 When you were born, were you: full-term, premature, don't know. 1 Full term 86, or more weeks premature 2, Don't know 4, TWI Twin or triplet Col#6 When you were born, were you a twin or triplet? 0 o 91, Yes 1, Page 1 of 24

2 BRSTFED Breast fed Col#7 When you were a baby, did your mother breast feed you? 0 o 19, Yes 54, Don't know 19, COFFEE Drink coffee each day Col#8 Do you usually drink coffee each day? 0 o 26, Yes 66, CUPREG Cups of regular coffee Col#9 How many cups of regular coffee (not decaf) do you usually drink each day? (Count tall [12 oz. or more] cups and espresso drinks made with double shots of espresso as 2 cups.) 0 one 13, cup 16, cups 26, cups 6, or more cups 1, , Sub-question of F42 V1 Q5 "Drink coffee each day". CUPDECAF Cups of decaf coffee Col#10 How many cups of decaf coffee do you usually drink each day? (Count tall [12 oz. or more] cups and espresso drinks made with double shots of espresso as 2 cups.) 0 one 35, cup 13, cups 12, cups 2, or more cups , Sub-question of F42 V1 Q5 "Drink coffee each day". Page 2 of 24

3 COFDRIP Method - Drip Col#11 How is the coffee usually made? (Mark one or two.) Drip 0 o 18, Yes 46, , Sub-question of F42 V1 Q5 "Drink coffee each day". COFESPRS Method - Espresso Col#12 How is the coffee usually made? (Mark one or two.) Espresso 0 o 63, Yes 1, , Sub-question of F42 V1 Q5 "Drink coffee each day". COFIST Method - Instant Col#13 How is the coffee usually made? (Mark one or two.) Instant 0 o 50, Yes 15, , Sub-question of F42 V1 Q5 "Drink coffee each day". COFBOIL Method - Boiled Col#14 How is the coffee usually made? (Mark one or two.) Boiled 0 o 64, Yes , Sub-question of F42 V1 Q5 "Drink coffee each day". COFPERC Method - Percolated Col#15 How is the coffee usually made? (Mark one or two.) Percolated 0 o 59, Yes 6, , Sub-question of F42 V1 Q5 "Drink coffee each day". Page 3 of 24

4 COFPRESS Method - French Press Col#16 How is the coffee usually made? (Mark one or two.) French Press 0 o 64, Yes , Sub-question of F42 V1 Q5 "Drink coffee each day". TEA Drink tea each day Col#17 The next set of questions ask about your coffee and tea drinking habits. Do you usually drink tea each day? (Do not include decaf or herbal tea.) 0 o 68, Yes 24, CUPTEA How many cups of tea Col#18 How many cups of tea do you usally drink each day? (Do not include decaf or herbal tea.) 1 1 cup 11, cups 9, cups 1, or more cups , Sub-question of F42 V1 Q6 "Drink tea each day". ALCOHL 12 or more drinks of alcohol Col#19 For the question below, one drink of alcohol is equal to one can of beer, one glass of wine, or one shot of liquor (whiskey, brandy or gin). During your entire life, have you had 12 drinks or more of any kind of alcoholic drink? 0 o 11, Yes 81, Page 4 of 24

5 DRKAG14 Drinks of alcohol (age 14-17) Col#20 For the question below, one drink of alcohol is equal to one can of beer, one glass of wine, or one shot of liquor (whiskey, brandy or gin). When you were between 14 and 17 years old, how many drinks of alcohol did you usually have? 0 one or less than 1 per month 75, each month 4, each week 1, each week each day or more each day , Sub-question of F42 V1 Q7 "12 or more drinks". DRKAG18 Drinks of alcohol (age 18-22) Col#21 For the question below, one drink of alcohol is equal to one can of beer, one glass of wine, or one shot of liquor (whiskey, brandy or gin). When you were between 18 and 22 years old, how many drinks of alcohol did you usually have? 0 one or less than 1 per month 41, each month 23, each week 9, each week 5, each day or more each day , Sub-question of F42 V1 Q7 "12 or more drinks". DRKAG23 Drinks of alcohol (age 23-29) Col#22 For the questions below, one drink of alcohol is equal to one can of beer, one glass of wine, or one shot of liquor (whiskey, brandy or gin). When you were between 23 and 29 years old, how many drinks of alcohol did you usually have? 0 one or less than 1 per month 24, each month 29, each week 15, each week 9, each day 2, or more each day , Sub-question of F42 V1 Q7 "12 or more drinks". Page 5 of 24

6 DRKAG30 Drinks of alcohol (age 30-49) Col#23 For the question below, one drink of alcohol is equal to one can of beer, one glass of wine, or one shot of liquor (whiskey, brandy or gin). When you were between 30 and 49 years old, how many drinks of alcohol did you usually have? 0 one or less than 1 per month 17, each month 24, each week 17, each week 14, each day 5, or more each day 1, , Sub-question of F42 V1 Q7 "12 or more drinks". DRKAG50 Drinks of alcohol (age 50) Col#24 For the question below, one drink of alcohol is equal to one can of beer, one glass of wine, or one shot of liquor (whiskey, brandy or gin). When you were about 50 years old, how many drinks of alcohol did you usually have? 0 one or less than 1 per month 24, each month 20, each week 13, each week 12, each day 8, or more each day 1, , Sub-question of F42 V1 Q7 "12 or more drinks". CHLVSMK Lived with smoker as a child Col#25 As a child (less than 18 years old), did you ever live with someone who smoked cigarettes inside your home? 0 o 33, Yes 58, Don't know 1, CHLVSMKY Years as child lived with smoker Col#26 As a child, how many years did you live with someone who smoked inside your home? 1 Less than 1 year years 2, years 5, years 49, , Sub-question of F42 V1 Q8 "Lived with smoker as child". Page 6 of 24

7 ADLVSMK Lived with smoker after age 18 Col#27 Since age 18, have you ever lived with someone (including a parent, husband, or other adult person) who smoked cigarettes inside your home? 0 o 24, Yes 68, ADLVSMKY Years as adult lived with smoker Col#28 Since age 18, how many years have you lived with someone who smoked cigarettes inside your home? 1 Less than 1 year 2, years 9, years 8, years 14, years 13, years 10, or more years 9, , Sub-question of F42 V1 Q9 "Lived with smoker after age 18". LVSMKW Live with smoker now Col#29 Does anyone living with you now smoke cigarettes inside your home? 0 o 61, Yes 6, , Sub-question of F42 V1 Q9 "Lived with smoker after age 18". PTRSMK Smoker - husband/partner Col#30 Please mark all the people who live with you now and who smoke cigarettes inside your home. Husband or partner 0 o 2, Yes 3, , Sub-question of F42 V1 Q9 "Lived with smoker after age 18". Sub-question of F42 V1 Q9.2 "Live with smoker now". Page 7 of 24

8 CHLDSMK Smoker - Son/daughter Col#31 Please mark all the people who live with you now and who smoke cigarettes inside your home. Son(s) or daughter(s) 0 o 4, Yes 2, , Sub-question of F42 V1 Q9 "Lived with smoker after age 18". Sub-question of F42 V1 Q9.2 "Live with smoker now". OTHSMK Smoker - Other person Col#32 Please mark all the people who live with you now and who smoke cigarettes inside your home. Other person/people 0 o 5, Yes 1, , Sub-question of F42 V1 Q9 "Lived with smoker after age 18". Sub-question of F42 V1 Q9.2 "Live with smoker now". WORKSMK Worked with smoker Col#33 Have you ever worked in a space where people smoked cigarettes? 0 o 23, Yes 69, WORKSMKY Years worked where people smoked Col#34 How many total years have you worked in a space where people smoked cigarettes? 1 Less than 1 year 3, years 14, years 14, years 17, years 11, years 5, or more years 2, , Sub-question of F42 V1 Q10 "Worked with smoker". Page 8 of 24

9 WRKSMKW Work with smoker now Col#35 Do you now work in a space where people smoke? 0 o 62, Yes 3, , Sub-question of F42 V1 Q10 "Worked with smoker". BSEEVR Breast self-exam ever Col#36 Have you ever done a breast self-examination (a breast exam on yourself)? 0 o 8, Yes 84, BSEUM1Y How many breast self exams in last 12 months Col#37 How many times have you done a breast self-exam in the last 12 months? 0 one 7, times 39, times 20, or more times 16, , Sub-question of F42 V1 Q11 "Breast self-exam ever". CBEEVR Physical breast exam ever Col#38 Have you ever had a breast physical exam done by a doctor, nurse, or physician assistant? 0 o 1, Yes 91, CBEUM5Y How many physical breast exams in last 5 years Col#39 How many of these exams have you had in the last 5 years? 0 one 2, exam 5, exams 8, exams 9, exams 12, or more exams 53, , Sub-question of F42 V1 Q12 "Physical breast exam ever". Page 9 of 24

10 CBELST How long ago was last breast exam Col#40 How long ago did you last have a breast exam by a doctor, nurse, or physician assistant? 0 Less than 1 year age 63, year ago 15, years ago 6, years ago 2, years ago 1, or more years ago 3, , Sub-question of F42 V1 Q12 "Physical breast exam ever". BRSTDS Benign breast disease Col#41 Has a doctor ever told you that you had benign breast disease or fibrocystic disease in your breasts? 0 o 64, Yes 28, MAM5Y Mammogram in last 5 years Col#42 Have you had a mammagram (x-ray of the breast to look for cancer or other breast problems) in the last 5 years? 0 o 5, Yes 86, , MAMUM5Y How many mammograms in last 5 years Col#43 How many mammograms have you had in the last 5 years? 1 1 5, , , , or more 42, , Sub-question of F42 V1 Q14 "Mammogram in last 5 years". Page 10 of 24

11 GEPWDR Used powder on genitals Col#44 Have you ever used powder on your private parts (genital areas)? 0 o 55, Yes 37, GEPWDRY Years used powder on genitals Col#45 The next question asks about the use of powders (talc, baby powder, deodorant powder). For how many years? 1 Less than 1 year 9, years 6, years 4, years 4, or more years 12, , Sub-question of F42 V1 Q15 "Used powder on genitals". DIAPHRAM Ever use a diaphragm Col#46 Did you ever use a diaphragm (a birth control device that fits over the opening of your womb)? 0 o 51, Yes 41, DIAPWDR Ever use powder on diaphragm Col#47 The next set of questions are about the use of powders (talc, baby powder, deodorant powder). Did you ever use powder on your diaphragm? 0 o 29, Yes 11, , Sub-question of F42 V1 Q16 "Ever use a diaphragm". Page 11 of 24

12 DIAPWDRY Years used powder on diaphragm Col#48 The next set of questions are about the use of powders (talc, baby powder, deodorant powder). For how many years did you use powder on your diaphragm? 1 Less than 1 year 2, years 3, years 2, years 2, or more years 1, , Sub-question of F42 V1 Q16 "Ever use a diaphragm". Sub-question of F42 V1 Q16.1 "Ever use powder on diaphragm". PADPWDR Ever used powder on a sanitary napkin Col#49 The next set of questions are about the use of powders (talc, baby powder, deodorant powder). Did you ever use powder on a sanitary napkin or pad? 0 o 71, Yes 21, PADPWDRY Years used powder on a sanitary napkin Col#50 The next set of questions are about the use of powders (talc, baby powder, deodorant powder). For how many years did you use powder on sanitary pads? 1 Less than 1 year 5, years 4, years 3, years 3, or more years 3, , Sub-question of F42 V1 Q17 "Ever used powder on sanitary". ELCBLKT Ever used an electric blanket Col#51 Have you ever used an electric blanket, electric mattress pad, or heated water bed on at least half the days in any one month period? 0 o 39, Yes 53, Page 12 of 24

13 ELCBLKTY Years used an electric blanket Col#52 How many years total did you use an electric blanket, electric mattress pad, or heated water bed? 1 Less than 1 year 4, years 14, years 12, years 11, or more years 11, , Sub-question of F42 V1 Q18 "Ever used electric blanket". ELCBLKTM Months used an electric blanket Col#53 How many months per year did you use an electric blanket, electric mattress pad, or heated water bed on at least half the days of the month? 1 Less than 1 month per year 2, months per year 20, months per year 20, months per year 4, months per year 5, , Sub-question of F42 V1 Q18 "Ever used electric blanket". ELCBLKO Electric blanket turned on Col#54 When you used the electric blanket, electric mattress pad, or heated water bed, did you leave it turned on most of the time while you were sleeping, or did you use it only to warm the bed before you went to sleep? 1 On most of the time 38, Warm the bed only 14, , Sub-question of F42 V1 Q18 "Ever used electric blanket". ELCBLKPY Used an electric blanket during past year Col#55 Have you used an electric blanket, electric mattress pad, or heated water bed during the past year? 0 o 30, Yes 22, , Sub-question of F42 V1 Q18 "Ever used electric blanket". RELIGIO Religion Col#56 Page 13 of 24

14 What is your religion? 0 one 6, Catholic 25, Baptist 9, Episcopalian or Anglican 5, Lutheran 6, Methodist 9, Presbyterian 6, Adventist Mormon/Latter Day Saints Other Christian 9, Jewish 7, Eastern (Buddhist, Hindu) Muslim Other 4, IDRCHOR Hours doing heavy chores Col#57 About how many hours each week do you usually spend doing heavy (strenous) indoor household chores such as scrubbing floors, sweeping, or vaccuuming? 1 Less than 1 hour 31, hours 41, hours 14, hours 3, or more hours 2, YRDWORKM Months doing yard work Col#58 About how many months during the year do you usually do things in the yard, such as mowing, raking, gardening, or shoveling snow? 1 Less than 1 month 39, months 16, months 16, months 9, or more months 10, Page 14 of 24

15 YRDWRKH Hours in week doing yard work Col#59 When you do these things in the yard, how many hours each week do you do them? 1 Less than 1 hour 7, hours 28, hours 10, hours 3, or more hours 2, , Sub-question of F42 V1 Q21 "Months doing yard work". SITTIG umber of hours spent sitting Col#60 During a usual day and night, about how many hours do you spend sitting? Be sure to include the time you spend sitting at work, sitting at the table eating, driving or riding in a car or bus, and sitting up watching TV or talking. 1 Less than 4 hours 10, hours 22, hours 21, hours 16, hours 11, hours 7, hours 2, or more hours 1, SLEEPIG umber of hours spent sleeping Col#61 During a usual day and night, about how many hours do you spend sleeping or lying down with your feet up? Be sure to include the time you spend sleeping or trying to sleep at night, resting or napping, and lying down watching TV. 1 Less than 4 hours 5, hours 2, hours 25, hours 42, hours 12, hours 2, hours or more hours FARM Ever lived or worked on farm Col#62 Did you ever live or work on a farm? 0 o 68, Yes 24, Page 15 of 24

16 FARMY Years on farm Col#63 For how many years did you live or work on a farm? 1 Less than 5 years 6, years 3, years 3, years 7, or more years 3, , Sub-question of F42 V1 Q24 "Ever lived or worked on farm". HAIRDYE Worked with hair dyes for year or more Col#64 Did you ever work for one year or more as a hairdresser, beautician, or cosmetologist where you worked with hair dyes? 0 o 90, Yes 2, HAIRDYEY Years worked with hair dyes Col#65 For how many years did you work as a hairdresser, beautician or cosmetologist? years years years years or more years , Sub-question of F42 V1 Q25 "Worked with hair dyes for year". JOBPAID Ever had a paid job Col#66 Have you ever had a job for which you were paid? 0 o 1, Yes 91, Page 16 of 24

17 JOBAGE1 Job 1 - Age started Col#67 What are the 3 full-time or part-time jobs that you have held the longest length of time since you were 18 years old? Please start with your most recent job. (If you worked less than one year at a job, write "01" in the boxes for total years worked.) Age Started this job (#1) 89,057 4, Sub-question of F42 V1 Q26 "Ever had a paid job". JOBY1 Job 1 - Years worked Col#68 What are the 3 full-time or part-time jobs that you have held the longest length of time since you were 18 years old? Please start with your most recent job. (If you worked less than one year at a job, write "01" in the boxes for total years worked.) Total number of years worked at this job (#1) 89,387 4, Sub-question of F42 V1 Q26 "Ever had a paid job". JOBAGE2 Job 2 - Age started Col#69 What are the 3 full-time or part-time jobs that you have held the longest length of time since you were 18 years old? Please start with your most recent job. (If you worked less than one year at a job, write "01" in the boxes for total years worked.) Age Started this job (#2) 74,768 18, Sub-question of F42 V1 Q26 "Ever had a paid job". JOBY2 Job 2 - Years worked Col#70 What are the 3 full-time or part-time jobs that you have held the longest length of time since you were 18 years old? Please start with your most recent job. (If you worked less than one year at a job, write "01" in the boxes for total years worked.) Total number of years worked at this job (#2) 75,321 18, Sub-question of F42 V1 Q26 "Ever had a paid job". JOBAGE3 Job 3 - Age started Col#71 What are the 3 full-time or part-time jobs that you have held the longest length of time since you were 18 years old? Please start with your most recent job. (If you worked less than one year at a job, write "01" in the boxes for total years worked.) Age Started this job (#3) 57,500 36, Sub-question of F42 V1 Q26 "Ever had a paid job". JOBY3 Job 3 - Years worked Col#72 Page 17 of 24

18 What are the 3 full-time or part-time jobs that you have held the longest length of time since you were 18 years old? Please start with your most recent job. (If you worked less than one year at a job, write "01" in the boxes for total years worked.) Total number of years worked at this job (#3) 58,062 35, Sub-question of F42 V1 Q26 "Ever had a paid job". HGTAG18F Height at 18 (feet) Col#73 How tall were you (without shoes on) at about age 18 (your tallest adult height) - feet 92,577 1, HGTAG18I Height at 18 (inches) Col#74 How tall were you (without shoes on) at about age 18 (your tallest adult height) - inches 91,496 2, WGTAG18 Weight at 18 (pounds) Col#75 What was your weight at about age 18 (when you were not pregnant)? 92,557 1, WGTAG35 Weight at 35 (pounds) Col#76 What was your weight at about age 35 (when you were not pregnant)? 92,530 1, WGTAG50 Weight at 50 (pounds) Col#77 What was your weight at about age 50 (when you were not pregnant)? 92, WGTMAX imum adult weight (pounds) Col#78 What was your maximum adult weight (the most you ever weighed since you were 18 years old) when you were not pregnant? 92,522 1, Page 18 of 24

19 WGTMAX18 weight (age 18-29) Col#79 How old were you when you were at your maximum adult weight? (Mark all that apply.) o 83, Yes 9, WGTMAX30 weight (age 30-39) Col#80 How old were you when you were at your maximum adult weight? (Mark all that apply.) o 86, Yes 6, WGTMAX40 weight (age 40-49) Col#81 How old were you when you were at your maximum adult weight? (Mark all that apply.) o 82, Yes 10, WGTMAX50 weight (age 50-59) Col#82 How old were you when you were at your maximum adult weight? (Mark all that apply.) o 57, Yes 35, WGTMAX60 weight (age 60-69) Col#83 How old were you when you were at your maximum adult weight? (Mark all that apply.) o 62, Yes 30, WGTMAX70 weight (age 70+) Col#84 How old were you when you were at your maximum adult weight? (Mark all that apply.) 70 years old or older 0 o 83, Yes 8, WGTMI imum adult weight (pounds) Col#85 Page 19 of 24

20 What was your minimum adult weight (the least you ever weighed since you were 18 years old)? 91,946 1, WGTMI18 weight (age 18-29) Col#86 How old were you when you were at your minimum adult weight? (Mark all that apply.) o 32, Yes 60, , WGTMI30 weight (age 30-39) Col#87 How old were you when you were at your minimum adult weight? (Mark all that apply.) o 74, Yes 18, , WGTMI40 weight (age 40-49) Col#88 How old were you when you were at your minimum adult weight? (Mark all that apply.) o 81, Yes 10, , WGTMI50 weight (age 50-59) Col#89 How old were you when you were at your minimum adult weight? (Mark all that apply.) o 85, Yes 7, , WGTMI60 weight (age 60-69) Col#90 How old were you when you were at your minimum adult weight? (Mark all that apply.) o 88, Yes 4, , Page 20 of 24

21 WGTMI70 weight (age 70+) Col#91 How old were you when you were at your minimum adult weight? (Mark all that apply.) 70 years old or older 0 o 90, Yes 1, , LT10LB Lost 10 pounds or more Col#92 Within the last 20 years, when you were not pregnant or sick, did you ever lose 10 pounds or more on purpose? 0 o 42, Yes 49, LT50LB Times lost >= 50 pounds Col#93 How many times did you lose 50 pounds or more? 0 one 41, times 5, times times or more times , Sub-question of F42 V1 Q35 "Lost 10 pounds or more". LST20_49 Times lost pounds Col#94 How many times did you lose at least 20 pounds, but not more than 49 pounds? 0 one 20, times 20, times 5, times 1, or more times , Sub-question of F42 V1 Q35 "Lost 10 pounds or more". Page 21 of 24

22 LST10_19 Times lost pounds Col#95 How many times did you lose at least 10 pounds, but not more than 19 pounds? 0 one 3, times 26, times 10, times 4, or more times 3, , Sub-question of F42 V1 Q35 "Lost 10 pounds or more". CWGT10LB Years at current weight Col#96 How long have you been within 10 pounds of your current weight (do not count times when you were pregnant or sick)? 87,346 6, LIVESTY Years lived in current state Col#97 How many years have you lived in the state you now live in? 1 Less than 5 years 3, years 3, years 7, years or more 78, USBOR Born in the U.S. Col#98 Computed from Form 42, question 38. Indicator variable for whether the participant was born in the U.S. 0 o 6, Yes 86, LVUSAG15 Living in the U.S. at age 15 Col#99 Computed from Form 42, question 39. Indicator variable of whether the participant lived in the US at age o 5, Yes 87, Page 22 of 24

23 LVUSAG35 Living in the U.S. at age 35 Col#100 Computed from Form 42, question 40. Indicator variable of whether the participant lived in the US at age o 3, Yes 89, LVUSAG50 Living in the U.S. at age 50 Col#101 Computed from Form 42, question 41. Indicator variable of whether the participant lived in the US at age o 1, Yes 91, USLG Lived in U.S. the longest of any country Col#102 Computed from Form 42, question 42. Indicator variable of whether the participant has lived in the US the longest of any country. 0 o 1, Yes 91, BRTHREG U.S. region of birth Col#103 Computed from Form 42, question 38. U.S. region of birth based on U.S. Census definition. If participant was born outside of the U.S., BRTHREG=0 (ot in U.S.). 0 ot born in U.S. 6, ortheast 25, Midwest 27, South 20, West 12, YRDMIWK utes/week of yard work Col#104 Computed from Form 42, questions 21 and utes per week of physical activity from yardwork. 92,322 1, YARDEXP Energy expended from yard work (MET-hours/week) Col#105 Computed from Form 42, questions 21 and Expenditure of energy from physical activity from yard work in MET-hours per week. 92,322 1, IHEAEXP Energy expended from heavy indoor chores (MET-hours/week) Col#106 Computed from Form 42, question 20. Expenditure of energy from physical activity from heavy indoor household chores in MET-hours per week. Page 23 of 24

24 93, IACT Hours/day spent sitting or lying Col#107 Computed from Form 42, questions 22 and 23. Hours per day of sedentary activity (sitting, sleeping or lying down). 92, Page 24 of 24

Clermont County Youth Health Survey Questions

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