Archived - Canadian Community Health Survey (CCHS)

Archived information

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Healthy Aging

Contact component
Household component
Survey introduction (INT)
Proxy interview (GR)
Age of respondent 2 (AN2)
General health (GEN)
Sleep 2 (SL2)
Height and weight (HWT)
Chronic conditions (CCC)
Health utility index (HUI)
Pain and discomfort (HUP)
Satisfaction with life scale (SLS)
Cognition control (CGT)
Cognition (COG)
Physical activities 2 (PA2)
Nutritional risk (NUR)
Oral health 3 (OH3)
Medication use (MED)
Dietary supplement use - vitamins and minerals (DS2)
Smoking (SMK)
Alcohol use (ALC)
Changes made to improve health (CIH)
Falls (FAL)
Instrumental activities of daily living (IAL)
Basic activities of daily living (ADL)
Health care utilization 2 (HC2)
Care receiving 1 (CR1)
Care receiving 2 (CR2)
Social support - availability (SSA)
Social participation (SPA)
Care giving (CAG)
Care giving expenses (CGE)
Depression (DEP)
Loneliness (LON)
Transportation (TRA)
Labour force (LBF)
Reasons for retirement (RET)
Retirement planning (RPL)
Home owner (OWN)
Income (INC)
Socio – demographic characteristics (SDC)
Administration information (ADM)
Administration - fictitious Name (ADF)
Consent to share (CLS)
Exit

Contact component

Note:

The following module only includes part of the questions asked during the CCHS – Healthy Aging interview. It includes what we believe may be of interest for data users.

Contact

CN_N01

INTERVIEWER: Record method of interview.
1 Telephone
2 Personal
( DK , RF are not allowed)

CN_N02

INTERVIEWER: Have you made contact?
1 Yes
2 No (Go to CN_END)
( DK , RF are not allowed)

CN_END

Interviewer introduction

II_R01

Hello, I’m [calling] from Statistics Canada. My name is …
INTERVIEWER: Introduce yourself using both your given and last names.
Press <Enter> to continue.
( DK , RF are not allowed)

II_END

Language of preference

LP_Q01

Would you prefer to continue in English or in French?
INTERVIEWER: Previous response was ["English" / "French" / "Other"].
1 English (Go to LP_END)
2 French (Go to LP_END)
3 Other
( DK , RF are not allowed)

LP_N02

INTERVIEWER: Select respondent’s preferred non-official language.
If necessary, ask: (What languge would you prefer?)
03 Chinese
04 Italian
05 Punjabi
06 Spanish
07 Portuguese
08 Polish
09 German
10 Vietnamese
11 Arabic
12 Tagalog
13 Greek
14 Tamil
15 Cree
16 Afghan
17 Cantonese
18 Hindi
19 Mandarin
20 Persian (Farsi)
21 Russian
22 Ukrainian
23 Urdu
24 Inuktitutrdu
25 Hungarian
26 Korean
27 Serbo–Croatian
28 Gujarati
29 Dari
90 Other – Specify
( DK , RF are not allowed)

LP_END

Initial contact

IC_R01

I’m calling regarding the Canadian Community Health Survey on Healthy Aging. All information collected in this survey will be kept strictly confidential.
INTERVIEWER: Press <Enter> to continue.
( DK , RF are not allowed)

IC_END

Household component

Note:

The following module only includes part of the questions asked during the CCHS interview. It includes what we believe may be of interest for data users.

RS_R01

The next few questions ask for important basic information about the people in your household.
INTERVIEWER: Press <Enter> to continue.
( DK , RF are not allowed)

RS_END

Usual Roster

USU_Q01

What are the names of all persons who usually live here?

USU_END

"Other" Roster 1

RS_Q04

Are there any other persons who usually live here but are now away at school, in hospital, or somewhere else?
1 Yes
2 No (Go to OTH1_END)
DK , RF (Go to OTH1_END)

OTH1_Q01

What are the names of the other people who live or stay here?
( DK , RF and null are not allowed)

OTH1_END

Age Without Date of Birth

ANDB_Q01

What is [respondent name]'s age?
Age in years
( MIN : 0) ( MAX : 130)
( DK , RF are not allowed)

ANDB_END

Sex

SEX_Q01

INTERVIEWER: Enter [respondent name]’s sex.
If necessary, ask: (Is [respondent name] male or female?)
1 Male
2 Female
( DK , RF are not allowed)

SEX_END

Marital status

MSNC_Q01

What is [respondent name]’s marital status? Is [he/she]:
INTERVIEWER: Read categories to respondent.
1 …married?
2 …living common–law?
3 …widowed?
4 …separated?
5 …divorced?
6 …single, never married?

MSNC_END

Education

ED_Q01

What is the highest grade of elementary or high school [respondent name] ever completed?
1 Grade 8 or lower (Québec: Secondary II or lower) (Go to EDU_Q03)
2 Grade 9 – 10 (Québec: Secondary III or IV, Newfoundland and Labrador: 1st year of secondary) (Go to EDU_Q03)
3 Grade 11 – 13 (Québec: Secondary V, Newfoundland and Labrador: 2nd to 4th year of secondary)
DK , RF (Go to EDU_Q03)

ED_Q02

Did [respondent name] graduate from high school (secondary school)?
1 Yes
2 No
DK , RF

ED_Q03

Has [respondent name] received any other education that could be counted towards a degree,certificate or diploma from an educational institution?
1 Yes
2 No (Go to EDU_END)
DK , RF (Go to EDU_END)

ED_Q04

What is the highest degree, certificate or diploma [respondent name] has obtained?
01 No post–secondary degree, certificate or diploma
02 Trade certificate or diploma from a vocational school or apprenticeship training
03 Non–university certificate or diploma from a community college, CEGEP , school of nursing, etc.
04 University certificate below bachelor’s level
05 Bachelor’s degree
06 University degree or certificate above bachelor’s degree
DK , RF

Canadian Forces

CAF_Q01

Is [respondent name] a full time member of the regular Canadian Armed Forces?
1 Yes
2 No
( DK , RF are not allowed)

CAF_END

Relationship without confirmation

RNC_Q1

What is the relationship of: [respondent name] [(Text sex, age)]to: [respondent name]? [(Text sex, age)]
01 Husband/Wife
02 Common–law partner
03 Father/Mother (Go to RNC_Q2A)
04 Son/Daughter (Go to RNC_Q2B)
05 Brother/Sister (Go to RNC_Q2C)
06 Foster father/mother
07 Foster son/daughter
08 Grandfather/mother
09 Grandson/daughter
10 In–law (Go to RNC_Q2D)
11 Other related (Go to RNC_Q2E)
12 Unrelated (Go to RNC_Q2F)

RNC_Q2A

What is the relationship of: [respondent name] [(Text sex, age)]
to: [respondent name]? [(Text sex, age)]
Is that a(n):
1 …birth father/mother?
2 …step father/mother?
3 …adoptive father/mother?

RNC_Q2B

What is the relationship of: [respondent name] [(Text sex, age)]
to: [respondent name]? [(Text sex, age)]
Is that a(n):
1 …birth son/daughter?
2 …step son/daughter?
3 …adopted son/daughter?

RNC_Q2C

What is the relationship of: [respondent name] [(Text sex, age)]
to: [respondent name]? [(Text sex, age)]
Is that a(n):
1 …full brother/sister?
2 …half brother/sister?
3 …step brother/sister?
4 …adopted brother/sister?
5 …foster brother/sister?

RNC_Q2D

What is the relationship of: [respondent name] [(Text sex, age)]
to: [respondent name]? [(Text sex, age)]
Is that a(n):
1 …father/mother–in–law?
2 …son/daughter–in–law?
3 …brother/sister–in–law?
4 …other in–law?

RNC_Q2E

What is the relationship of: [respondent name] [(Text sex, age)]
to: [respondent name]? [(Text sex, age)]
Is that a(n):
1 …uncle/aunt?
2 …cousin?
3 …nephew/niece?
4 …other relative?

RNC_Q2F

What is the relationship of: [respondent name] [(Text sex, age)]
to: [respondent name]? [(Text sex, age)]
Is that a(n):
1 …boyfriend/girlfriend?
2 …room–mate?
3 …other?

RNC_END

Survey introduction (INT)

INT_BEG

Standard block
External variables required:
CN_N01: type of contact (1 = telephone, 2 = personal) from CN block
PE_Q01: first name of specific respondent from USU block
PE_Q02: last name of specific respondent from USU block
Screen display:
Display on header bar PE_Q01 and PE_Q02 separated by a space

INT_R01

This survey is conducted under the authority of the Statistics Act and will collect information on some of the factors that contribute to healthy aging such as general health and well–being, use of health care services, social participation, as well as work and retirement transition. Data from the survey will be used to evaluate, plan and improve health and social policies and programs for older Canadians.
INTERVIEWER: Press <Enter> to continue.

INT_R02

Your answers will be kept strictly confidential, will not be disclosed without yourconsent and will only be used for statistical purposes. While participation is voluntary, your assistance is essential if the results are to be accurate. (Registration#: STC/HLT–082–75431)
INTERVIEWER: Press <Enter> to continue.

INT_END

Proxy interview (GR)

GR_BEG

Content block
External variables required:
PERSONID: identifier of specific respondent in household
PE_Q01: first name of specific respondent from USU block
PE_Q02: last name of specific respondent from USU block
Screen display:
Display on header bar PE_Q01 and PE_Q02 separated by a space

GR_N01

INTERVIEWER Who is providing the information for this person´s component?
( DK , RF are not allowed)

Note:

Screen display:
Display all members of the household (PERSONID and ^PE_Q01 ^PE_Q02). It is possible to have up to 20 members in a household.

GR_C01

If GR_N01 = selected respondent, go to GR_END.
Otherwise, go to GR_N01A.

GR_N01A

INTERVIEWER Do you want to complete this component by proxy?
1 Yes (Go to GR_N02)
2 No
( DK , RF are not allowed) Go to GR_END

GR_E01A

You may not proceed with the rest of this questionnaire. Please press <F10> to exit, or return and update GR_N01 or GR_N01A.

Note:

Trigger hard edit if GR_N01A = 2 and not Selected Respondent.

GR_N02

INTERVIEWER Record the reason why this component is being completed by proxy.
(80 spaces)
( DK , RF are not allowed)

GR_END

Age of respondent 2 (AN2)

AN2_BEG

Survey block
External variables required:
SPECRESPNAME: name of specific respondent from ANDB block
PROXMODE: proxy identifier from the GR block
DOAN2: do block flag from sample file
FNAME: selected respondent's first name from household component
ANDB_Q01: age of selected respondent from household component
DVDATE: date of birth from DATE block
REFDATE: system date

AN2_C01

If DOAN2 = 1, go to AN2_D01.
Otherwise, go to AN2_ END.

Note:

Trigger soft edit

AN2_D01

(not applicable)

AN2_R01

For some of the questions I’ll be asking, I need to know ^YOUR2 exact date of birth.
INTERVIEWER: Press <Enter> to continue.

AN2_B01

Call Date block (DATE).

AN2_D02

Calculate DV_AGE1 based on DVDATE and REFDATE.

AN2_D03

If DV_AGE1 < > null, DV_AGE2 = DV_AGE1.
Otherwise, DV_AGE2 = ANDB_Q01.

AN2_Q03

So ^YOUR1 age is ^DV_AGE2. Is that correct?
1 Yes (Go to AN2_D05)
2 No, return and correct date of birth (Go to AN2_B01)
3 No, collect age (Go to AN2_Q04)
( DK , RF are not allowed)

AN2_Q04

What is ^YOUR1 age?
Age in years
( MIN : 0) ( MAX : 130)
( DK , RF are not allowed)

AN2_D04

(not applicable)

AN2_D05

If AN2_Q03 = 3, CURRAGE = AN2_Q04.
Otherwise, CURRAGE = DV_AGE2.

AN2_C06

If CURRAGE < 45, go to AN2_R06.
Otherwise, go to AN2_END.

AN2_R06

Because ^YOU1 ^ARE less than 45 years old, ^YOU1 ^ARE not eligible to participate in the Canadian Community Health Survey on Healthy Aging.
INTERVIEWER: Press <Enter> to continue.

AN2_END

General health (GEN)

GEN_BEG

Content block
External variables required:
SPECRESPNAME: name of specific respondent from ANDB block
PROXMODE: proxy identifier, from the GR block.
FNAME: first name of respondent from household block.
DOGEN: do block flag, from the sample file.

GEN_C01

If DOGEN = 1, go to GEN_D01.
Otherwise, go to GEN_END.

GEN_D01

(not applicable)

GEN_R01

This survey deals with various aspects of ^YOUR2 health. I’ll be asking about such things as physical activity, social relationships and health status. By health, we mean not only the absence of disease or injury but also physical, mental and social well–being.
INTERVIEWER: Press <Enter> to continue.

GEN_Q01

In general, would you say ^YOUR2 health is:
INTERVIEWER: Read categories to respondent.
1 …excellent?
2 …very good?
3 …good?
4 …fair?
5 …poor?
DK , RF

GEN_Q02

Compared to one year ago, how would you say ^YOUR2 health is now? Is it:
INTERVIEWER : Read categories to respondent.
1 …much better now than 1 year ago?
2 …somewhat better now (than 1 year ago)?
3 …about the same as 1 year ago?
4 …somewhat worse now (than 1 year ago)?
5 …much worse now (than 1 year ago)?
DK , RF

GEN_C02A

If proxy interview, go to GEN_Q07.
Otherwise, go to GEN_Q02A

GEN_Q02A

Using a scale of 0 to 10 where 0 means "Very dissatisfied" and 10 means "Very satisfied", how ^DOVERB ^YOU1 feel about ^YOUR1 life as a whole right now?
00 Very dissatisfied
01
02
03
04
05
06
07
08
09
10 Very satisfied
DK , RF

GEN_Q02B

In general, would you say your mental health is:
INTERVIEWER : Read categories to respondent.
1 …excellent?
2 …very good?
3 …good?
4 …fair?
5 …poor?
DK , RF

GEN_Q07

Thinking about the amount of stress in ^YOUR1 life, would you say that most days are:
INTERVIEWER : Read categories to respondent.
1 …not at all stressful?
2 …not very stressful?
3 …a bit stressful?
4 …quite a bit stressful?
5 …extremely stressful?
DK , RF

GEN_C08A

If proxy interview, go to GEN_END.
Otherwise, go to GEN_Q08.

GEN_Q08

Have you worked at a job or business at any time in the past 12 months?
1 Yes
2 No (Go to GEN_Q10)
DK , RF (Go to GEN_Q10)

GEN_Q09

The next question is about your main job or business in the past 12 months. Would you say that most days at work were:
INTERVIEWER : Read categories to respondent.
1 …not at all stressful?
2 …not very stressful?
3 …a bit stressful?
4 …quite a bit stressful?
5 …extremely stressful?
DK , RF

GEN_Q10

How would you describe your sense of belonging to your local community? Would you say it is:
INTERVIEWER : Read categories to respondent.
1 …very strong?
2 …somewhat strong?
3 …somewhat weak?
4 …very weak?
DK , RF

GEN_END

Sleep 2 (SL2)

SL2_BEG

Content block
External variables required:
SPECRESPNAME: name of specific respondent from ANDB block
PROXMODE: proxy identifier, from the GR block.
FNAME: first name of respondent from household block.
DOSL2: do block flag, from the sample file.

SL2_C01A

If (DOSL2 = 1), go to SL2_C01B.
Otherwise, go to SL2_END.

SL2_C01B

If PROXMODE = 1, go to SL2_R01.
Otherwise, go to SL2_END.

SL2_R01

Now a question about sleep.
INTERVIEWER: Press <Enter> to continue.

SL2_Q02

How often ^DOVERB ^YOU2 have trouble going to sleep or staying asleep?
INTERVIEWER: Read categories to respondent.
1 None of the time
2 A little of the time
3 Some of the time
4 Most of the time
5 All of the time
DK , RF

SL2_END

Height and weight (HWT)

HWT_BEG

Content block
External variables required:
PROXSEX: sex of the respondent from the household roster.
PROXMODE: proxy identifier, from the GR block.
FNAME: first name of respondent from household block.
DOHWT: do block flag, from the sample file.
CURRAGE: age of respondent from the AN2 block.
PE_Q01: first name of specific respondent from USU block.
PE_Q02: last name of specific respondent from USU block.
Screen display:
Display on header bar PE_Q01 and PE_Q02 separated by a space.

HWT_C1

If DOHWT = 1, go to HWT_C2.
Otherwise, go to HWT_END.

HWT_C2

If PROXYMODE = 2 and SEX_Q01 = 2 and (14 < CURRAGE < 50), go to HWT_Q1.
Otherwise, go to HWT_Q2.

HWT_Q1

It is important to know when analyzing health whether or not the person is pregnant. Are you pregnant?
1 Yes (Go to HWT_END)
2 No
DK , RF

HWT_Q2

The next questions are about height and weight. How tall ^ARE ^YOU2 without shoes on?
0 Less than 1’ / 12" (less than 29.2 cm. )
1 1’0" to 1’11" / 12" to 23" (29.2 to 59.6 cm. )
2 2’0" to 2’11" / 24" to 35" (59.7 to 90.1 cm. )
3 3’0" to 3’11" / 36" to 47" (90.2 to 120.6 cm. ) (Go to HWT_N2C)
4 4’0" to 4’11" / 48" to 59" (120.7 to 151.0 cm. ) (Go to HWT_N2D)
5 5’0" to 5’11" (151.1 to 181.5 cm. ) (Go to HWT_N2E)
6 6’0" to 6’11" (181.6 to 212.0 cm. ) (Go to HWT_N2F)
7 7’0" and over (212.1 cm. and over) (Go to HWT_Q3)
DK , RF (Go to HWT_Q3)

HWT_E2

The selected height is too short for a [current age] year old respondent. Please return and correct.

Note:

Trigger hard edit if HWT_Q2 < 3.

HWT_N2A

INTERVIEWER : Select the exact height.
00 1’0" / 12" (29.2 to 31.7 cm. )
01 1’1" / 13" (31.8 to 34.2 cm. )
02 1’2" / 14" (34.3 to 36.7 cm. )
03 1’3" / 15" (36.8 to 39.3 cm. )
04 1’4" / 16" (39.4 to 41.8 cm. )
05 1’5" / 17" (41.9 to 44.4 cm. )
06 1’6" / 18" (44.5 to 46.9 cm. )
07 1’7" / 19" (47.0 to 49.4 cm. )
08 1’8" / 20" (49.5 to 52.0 cm. )
09 1’9" / 21" (52.1 to 54.5 cm. )
10 1’10" / 22" (54.6 to 57.1 cm. )
11 1’11" / 23" (57.2 to 59.6 cm. )
DK , RF

HWT_N2B

INTERVIEWER : Select the exact height.
00 2’0" / 24" (59.7 to 62.1 cm. )
01 2’1" / 25" (62.2 to 64.7 cm. )
02 2’2" / 26" (64.8 to 67.2 cm. )
03 2’3" / 27" (67.3 to 69.8 cm. )
04 2’4" / 28" (69.9 to 72.3 cm. )
05 2’5" / 29" (72.4 to 74.8 cm. )
06 2’6" / 30" (74.9 to 77.4 cm. )
07 2’7" / 31" (77.5 to 79.9 cm. )
08 2’8" / 32" (80.0 to 82.5 cm. )
09 2’9" / 33" (82.6 to 85.0 cm. )
10 2’10" / 34" (85.1 to 87.5 cm. )
11 2’11" / 35" (87.6 to 90.1 cm. )
DK , RF

HWT_N2C

INTERVIEWER : Select the exact height.
00 3’0" / 36" (90.2 to 92.6 cm. )
01 3’1" / 37" (92.7 to 95.2 cm. )
02 3’2" / 38" (95.3 to 97.7 cm. )
03 3’3" / 39" (97.8 to 100.2 cm. )
04 3’4" / 40" (100.3 to 102.8 cm. )
05 3’5" / 41" (102.9 to 105.3 cm. )
06 3’6" / 42" (105.4 to 107.9 cm. )
07 3’7" / 43" (108.0 to 110.4 cm. )
08 3’8" / 44" (110.5 to 112.9 cm. )
09 3’9" / 45" (113.0 to 115.5 cm. )
10 3’10" / 46" (115.6 to 118.0 cm. )
11 3’11" / 47" (118.1 to 120.6 cm. )
DK , RF
Go to HWT_Q3

HWT_N2D

INTERVIEWER : Select the exact height.
00 4’0" / 48" (120.7 to 123.1 cm. )
01 4’1" / 49" (123.2 to 125.6 cm. )
02 4’2" / 50" (125.7 to 128.2 cm. )
03 4’3" / 51" (128.3 to 130.7 cm. )
04 4’4" / 52" (130.8 to 133.3 cm. )
05 4’5" / 53" (133.4 to 135.8 cm. )
06 4’6" / 54" (135.9 to 138.3 cm. )
07 4’7" / 55" (138.4 to 140.9 cm. )
08 4’8" / 56" (141.0 to 143.4 cm. )
09 4’9" / 57" (143.5 to 146.0 cm. )
10 4’10" / 58" (146.1 to 148.5 cm. )
11 4’11" / 59" (148.6 to 151.0 cm. )
DK , RF
Go to HWT_Q3

HWT_N2E

INTERVIEWER : Select the exact height.
00 5’0" (151.1 to 153.6 cm. )
01 5’1" (153.7 to 156.1 cm. )
02 5’2" (156.2 to 158.7 cm. )
03 5’3" (158.8 to 161.2 cm. )
04 5’4" (161.3 to 163.7 cm. )
05 5’5" (163.8 to 166.3 cm. )
06 5’6" (166.4 to 168.8 cm. )
07 5’7" (168.9 to 171.4 cm. )
08 5’8" (171.5 to 173.9 cm. )
09 5’9" (174.0 to 176.4 cm. )
10 5’10" (176.5 to 179.0 cm. )
11 5’11" (179.1 to 181.5 cm. )
DK , RF
Go to HWT_Q3

HWT_N2F

INTERVIEWER : Select the exact height.
00 6’0" (181.6 to 184.1 cm. )
01 6’1" (184.2 to 186.6 cm. )
02 6’2" (186.7 to 189.1 cm. )
03 6’3" (189.2 to 191.7 cm. )
04 6’4" (191.8 to 194.2 cm. )
05 6’5" (194.3 to 196.8 cm. )
06 6’6" (196.9 to 199.3 cm. )
07 6’7" (199.4 to 201.8 cm. )
08 6’8" (201.9 to 204.4 cm. )
09 6’9" (204.5 to 206.9 cm. )
10 6’10" (207.0 to 209.5 cm. )
11 6’11" (209.6 to 212.0 cm. )
DK , RF

HWT_D3

(not applicable)

HWT_Q3

How much ^DOVERB ^YOU1 weigh?
INTERVIEWER: Enter amount only.
Weight
( MIN : 1) ( MAX : 575)
DK , RF (Go to HWT_END)

HWT_N4

INTERVIEWER: Was that in pounds or kilograms?
1 Pounds
2 Kilograms
( DK , RF are not allowed)

HWT_E4

An unusual value has been entered. Please confirm.

Note:

Trigger soft edit if ((HWT_Q3 > 300 and HWT_N4 = 1) or (HWT_Q3 > 136 and HWT_N4 = 2)) or ((HWT_Q3 < 60 and HWT_N4 = 1) or (HWT_Q3 < 27 and HWT_N4 = 2)).

HWT_C4

If proxy interview, go to HWT_END.
Otherwise, go to HWT_Q4.

HWT_Q4

Do you consider yourself:
INTERVIEWER: Read categories to respondent.
1 …overweight?
2 …underweight?
3 …just about right?
DK , RF

HWT_END

Chronic conditions (CCC)

CCC_BEG

Content block
External variables required:
PROXMODE: proxy identifier from the GR block
FNAME: first name of respondent from household component
DOCCC: do block flag from the sample file
RESPGENDER: sex of selected respondent from household component
PE_Q01: first name of specific respondent from USU block
PE_Q02: last name of specific respondent from USU block
Screen display:
Display on header bar PE_Q01 and PE_Q02 separated by a space

CCC_C001

If DOCCC = 1, go to CCC_R001.
Otherwise, go to CCC_ END.

CCC_R001

Now I’d like to ask about certain chronic health conditions which AYOU2 may have.We are interested in "long–term conditions" which are expected to last, or have already lasted, 6 months or more and that have been diagnosed by a health professional.
INTERVIEWER: Press <Enter> to continue.

CCC_D031

(not applicable)

CCC_Q031

^DOVERB_C ^YOU2 have asthma?
1 Yes
2 No
DK
RF (Go to CCC_END)

CCC_Q051

^DOVERB_C ^YOU2 have arthritis, excluding fibromyalgia?
1 Yes
2 No
DK , RF

CCC_Q053

(^DOVERB_C ^YOU1 have:)
…osteoporosis?
1 Yes
2 No
DK , RF

CCC_Q061

(^DOVERB_C ^YOU1 have:)
…back problems, excluding fibromyalgia and arthritis?
1 Yes
2 No
DK , RF

CCC_Q071

(^DOVERB_C ^YOU2 have:)
…high blood pressure?
1 Yes (Go to CCC_Q73)
2 No
DK , RF

CCC_Q072

^HAVE_C ^YOU2 ever been diagnosed with high blood pressure?
1 Yes
2 No (Go to CCC_Q081)
DK , RF (Go to CCC_Q081)

CCC_Q073

In the past month, ^HAVE ^YOU2 taken any medication for high blood pressure?
1 Yes
2 No
DK , RF

CCC_C073A

If RESPGENDER = 2, go to CCC_Q073A.
Otherwise, go to CCC_Q081.

CCC_Q073A

^WERE_C ^YOU2 pregnant when ^YOU1 ^WERE diagnosed with high blood pressure?
1 Yes
2 No (Go to CCC_Q073)
DK , RF (Go to CCC_Q081)

CCC_Q073B

Other than when ^YOU1 ^WERE pregnant, was there any other time when ^YOU1 ^WERE diagnosed with high blood pressure?
1 Yes
2 No
DK , RF

CCC_Q081

Remember, we are interested in "long–term conditions" that have been diagnosed by a health professional.^DOVERB_C ^YOU2 have migraine headaches?
1 Yes
2 No
DK , RF

CCC_Q091A

(^DOVERB_C ^YOU1 have:)
…chronic bronchitis?
1 Yes
2 No
DK , RF

CCC_Q091E

(^DOVERB_C ^YOU1 have:)
…emphysema?
1 Yes
2 No
DK , RF

CCC_Q091F

(^DOVERB_C ^YOU2 have:)
…chronic obstructive pulmonary disease (COPD)?
1 Yes
2 No
DK , RF

CCC_Q101

(^DOVERB_C ^YOU2 have:)
…diabetes?
1 Yes
2 No
DK , RF

CCC_Q119

(^DOVERB_C ^YOU1 have:)
…angina?
1 Yes
2 No
DK , RF

CCC_Q120

^HAVE_C ^YOU1 ever had a heart attack?
1 Yes
2 No
DK , RF

CCC_C121

If CCC_Q119 = 1 or CCC_Q120 = 1, go to CCC_Q131.
Otherwise, go to CCC_Q121.

CCC_Q121

^DOVERB_C ^YOU2 have heart disease?
INTERVIEWER : Include congestive heart failure.
1 Yes
2 No
DK , RF

Note:

At the time of data processing, if the respondent reported having either angina (CCC_Q119 = 1) or a heart attack (CCC_Q120 = 1), then the variable for heart disease will be set to "Yes" (CCC_Q121 = 1).

CCC_Q131

(Remember, we are interested in "long–term conditions" that have been diagnosed by a health professional.)^DOVERB_C ^YOU2 have cancer?
1 Yes (Go to CCC_Q141)
2 No
DK , RF

CCC_Q132

^HAVE_C ^YOU1 ever been diagnosed with cancer?
1 Yes
2 No
DK , RF

CCC_Q141

^DOVERB_C ^YOU1 have:…intestinal or stomach ulcers?
1 Yes
2 No
DK , RF

CCC_Q151

^DOVERB_C ^YOU2 suffer from the effects of a stroke?
1 Yes
2 No
DK , RF

CCC_Q161

(^DOVERB_C ^YOU2 suffer:)
…from urinary incontinence?
1 Yes
2 No
DK , RF

CCC_Q171

^DOVERB_C ^YOU1 suffer from a bowel disorder such as Crohn’s Disease, ulcerative colitis, Irritable Bowel Syndrome or bowel incontinence?
1 Yes
2 No
DK , RF

CCC_Q181

Remember, we are interested in "long–term conditions" that have been diagnosed by a health professional.^DOVERB_C ^YOU2 have:
…Alzheimer’s Disease or any other dementia?
1 Yes
2 No
DK , RF

CCC_Q183

(^DOVERB_C ^YOU2 have:)
…Parkinson’s Disease?
1 Yes
2 No
DK , RF

CCC_Q191

(^DOVERB_C ^YOU2 have:)
…cataracts?
1 Yes
2 No
DK , RF

CCC_Q201

(^DOVERB_C ^YOU2 have:)
…glaucoma?
1 Yes
2 No
DK , RF

CCC_Q211

(^DOVERB_C ^YOU2 have:)
…a thyroid condition?
1 Yes
2 No
DK , RF

CCC_Q280

^DOVERB_C ^YOU1 have a mood disorder such as depression, bipolar disorder, mania or dysthymia?
INTERVIEWER : Include manic depression.
1 Yes
2 No
DK , RF

CCC_Q290

^DOVERB_C ^YOU1 have an anxiety disorder such as a phobia, obsessive–compulsive disorder or a panic disorder?
1 Yes
2 No
DK , RF

CCC_Q901

^DOVERB_C ^YOU2 have any other long–term physical or mental condition that has been diagnosed by a health professional?
1 Yes
2 No (Go to CCC_END)
DK , RF (Go to CCC_END)

CCC_S901

INTERVIEWER : Specify.
(80 spaces)
DK , RF

CCC_END

Health utility index (HUI)

HUI_BEG

Content block
External variables required:
PROXMODE: proxy identifier from the GR block
FNAME: first name of selected respondent
DOHUI: do block flag from sample file
PE_Q01: first name of specific respondent from USU block
PE_Q02: last name of specific respondent from USU block
Screen display:
Display on header bar PE_Q01 and PE_Q02 separated by a space

HUI_C01

If DOHUI = 1, go to HUI_R01.
Otherwise, go to HUI_END.

HUI_R01

The next set of questions asks about ^YOUR2 day–to–day health. The questions are not about illnesses like colds that affect people for short periods of time. They are concerned with a person’s usual abilities. You may feel that some of these questions do not apply to ^YOU2, but it is important that we ask the same questions of everyone.
INTERVIEWER : Press <Enter> to continue.

Note:

Vision

HUI_Q01

^ARE_C ^YOU1 usually able to see well enough to read ordinary newsprint without glasses or contact lenses?
1 Yes (Go to HUI_Q04)
2 No
DK , RF (Go to HUI_END)

HUI_Q02

^ARE_C ^YOU1 usually able to see well enough to read ordinary newsprint with glasses or contact lenses?
1 Yes (Go to HUI_Q04)
2 No
DK , RF

HUI_Q03

^ARE_C ^YOU1 able to see at all?
1 Yes
2 No (Go to HUI_Q06)
DK , RF (Go to HUI_Q06)

HUI_Q04

^ARE_C ^YOU1 able to see well enough to recognize a friend on the other side of the street without glasses or contact lenses?
1 Yes (Go to HUI_Q06)
2 No
DK , RF (Go to HUI_Q06)

HUI_Q05

^ARE_C ^YOU1 usually able to see well enough to recognize a friend on the other side of the street with glasses or contact lenses?
1 Yes
2 No
DK , RF

Note:

Hearing

HUI_Q06

^ARE_C ^YOU2 usually able to hear what is said in a group conversation with at least 3 other people without a hearing aid?
1 Yes (Go to HUI_Q10)
2 No
DK , RF (Go to HUI_Q10)

HUI_Q07

^ARE_C ^YOU1 usually able to hear what is said in a group conversation with at least 3 other people with a hearing aid?
1 Yes (Go to HUI_Q08)
2 No
DK , RF

HUI_Q07A

^ARE_C ^YOU1 able to hear at all?
1 Yes
2 No (Go to HUI_Q10)
DK , RF (Go to HUI_Q10)

HUI_Q08

^ARE_C ^YOU1 usually able to hear what is said in a conversation with one other person in a quiet room without a hearing aid?
1 Yes (Go to HUI_Q10)
2 No
DK
RF (Go to HUI_Q10)

HUI_Q09

^ARE_C ^YOU1 usually able to hear what is said in a conversation with one other person in a quiet room with a hearing aid?
1 Yes
2 No
DK , RF

Note:

Speech

HUI_Q10

^ARE_C ^YOU2 usually able to be understood completely when speaking with strangers in ^YOUR1 own language?
1 Yes (Go to HUI_Q14)
2 No
DK
RF (Go to HUI_Q14)

HUI_Q11

^ARE_C ^YOU1 able to be understood partially when speaking with strangers?
1 Yes
2 No
DK , RF

HUI_Q12

^ARE_C ^YOU1 able to be understood completely when speaking with those who know ^HIMHER well?
1 Yes (Go to HUI_Q14)
2 No
DK
RF (Go to HUI_Q14)

HUI_Q13

^ARE_C ^YOU1 able to be understood partially when speaking with those who know ^HIMHER well?
1 Yes
2 No
DK , RF

Note:

Getting Around

HUI_Q14

^ARE_C ^YOU2 usually able to walk around the neighbourhood without difficulty and without mechanical support such as braces, a cane or crutches?
1 Yes (Go to HUI_Q21)
2 No
DK , RF (Go to HUI_Q21)

HUI_Q15

^ARE_C ^YOU1 able to walk at all?
1 Yes
2 No (Go to HUI_Q18)
DK , RF (Go to HUI_Q18)

HUI_Q16

^DOVERB_C ^YOU1 require mechanical support such as braces, a cane or crutches to be able to walk around the neighbourhood?
1 Yes
2 No
DK , RF

HUI_Q17

^DOVERB_C ^YOU1 require the help of another person to be able to walk?
1 Yes
2 No
DK , RF

HUI_Q18

^DOVERB_C ^YOU1 require a wheelchair to get around?
1 Yes
2 No (Go to HUI_Q21)
DK , RF (Go to HUI_Q21)

HUI_Q19

How often ^DOVERB ^YOU1 use a wheelchair?
INTERVIEWER : Read categories to respondent.
1 Always
2 Often
3 Sometimes
4 Never
DK , RF

HUI_Q20

^DOVERB_C ^YOU1 need the help of another person to get around in the wheelchair?
1 Yes
2 No
DK , RF

Note:

Hands and Fingers

HUI_Q21

^ARE_C ^YOU2 usually able to grasp and handle small objects such as a pencil or scissors?
1 Yes (Go to HUI_Q25)
2 No
DK , RF (Go to HUI_Q25)

HUI_Q22

^DOVERB_C ^YOU1 require the help of another person because of limitations in the use of hands or fingers?
1 Yes
2 No (Go to HUI_Q24)
DK , RF (Go to HUI_Q24)

HUI_Q23

^DOVERB_C ^YOU1 require the help of another person with:
INTERVIEWER : Read categories to respondent.
1 …some tasks?
2 …most tasks?
3 …almost all tasks?
4 …all tasks?
DK , RF

HUI_Q24

^DOVERB_C ^YOU1 require special equipment, for example, devices to assist in dressing, because of limitations in the use of hands or fingers?
1 Yes
2 No
DK , RF

Note:

Feelings

HUI_D25

If PROXMODE = 1, YOURSLF1 = "^FNAME".
Otherwise, YOURSLF1 = "yourself".

HUI_Q25

Would you describe ^YOURSLF1 as being usually:
INTERVIEWER : Read categories to respondent.
1 …happy and interested in life?
2 …somewhat happy?
3 …somewhat unhappy?
4 …unhappy with little interest in life?
5 …so unhappy that life is not worthwhile?
DK , RF

Note:

Memory

HUI_Q26

How would you describe ^YOUR1 usual ability to remember things?
INTERVIEWER : Read categories to respondent.
1 Able to remember most things
2 Somewhat forgetful
3 Very forgetful
4 Unable to remember anything at all
DK , RF

Note:

Thinking

HUI_Q27

How would you describe ^YOUR1 usual ability to think and solve day–to–day problems?
INTERVIEWER : Read categories to respondent.
1 Able to think clearly and solve problems
2 Having a little difficulty
3 Having some difficulty
4 Having a great deal of difficulty
5 Unable to think or solve problems
DK , RF

HUI_END

Pain and discomfort (HUP)

HUP_BEG

Content block
External variables required:
PROXMODE: proxy identifier, from the GR block
FNAME: first name of selected respondent
DOHUP: do block flag from sample file
DOHUI: do block flag from sample file
PE_Q01: first name of specific respondent from USU block
PE_Q02: last name of specific respondent from USU block
Screen display:
Display on header bar PE_Q01 and PE_Q02 seperated by a space

HUP_C01

If DOHUP = 1, go to HUP_C02.
Otherwise, go to HUP_END.

HUP_C02

If DOHUI = 1, go to HUP_Q28.
Otherwise, go to HUP_R01.

HUP_R01

The next questions are about pain and discomfort people may experience in their day to day lives.
INTERVIEWER: Press <Enter> to continue.

HUP_Q28

^ARE_C ^YOU2 usually free of pain or discomfort?
1 Yes (Go to HUP_END)
2 No
DK , RF (Go to HUP_END)

HUP_Q29

How would you describe the usual intensity of ^YOUR1 pain or discomfort?
INTERVIEWER : Read categories to respondent.
1 Mild
2 Moderate
3 Severe
DK , RF

HUP_Q30

How many activities does ^YOUR1 pain or discomfort prevent?
INTERVIEWER : Read categories to respondent.
1 None
2 A few
3 Some
4 Most
DK , RF

HUP_END

Satisfaction with life scale (SLS)

SLS_BEG

This module is the satisfaction with life scale developed by Dr. Ed Diener (University ofIllinois at Urbana – Champaign). This instrument is in the public domain.
Content block
External variables required:
PROXMODE: proxy identifier, from the GR block.
FNAME: first name of respondent from household block.
DOSLS: do block flag, from the sample file.

SLS_C01A

If DOSLS = 1, go to SLS_C01B.
Otherwise, go to SLS_END.
SLS_C01B If PROXMODE = 1, go to SLS_END.
Otherwise, go to SLS_R01.

SLS_R01

(Please refer to page 1 of the booklet.)Now a series of statements that people might use to describe their satisfaction with their lives. Please tell me if you strongly disagree, disagree, slightly disagree, neither agree nor disagree, slightly agree, agree, or strongly agree.
INTERVIEWER : Press <Enter> to continue.

SLS_Q01

In most ways, my life is close to my ideal.
1 Strongly disagree
2 Disagree
3 Slightly disagree
4 Neither agree nor disagree
5 Slightly agree
6 Agree
7 Strongly agree
DK
RF (Go to SLS_END)

SLS_Q02

The conditions of my life are excellent.
1 Strongly disagree
2 Disagree
3 Slightly disagree
4 Neither agree nor disagree
5 Slightly agree
6 Agree
7 Strongly agree
DK , RF

SLS_Q03

I am satisfied with my life.
1 Strongly disagree
2 Disagree
3 Slightly disagree
4 Neither agree nor disagree
5 Slightly agree
6 Agree
7 Strongly agree
DK , RF

SLS_Q04

So far, I have gotten the important things I want in life.
1 Strongly disagree
2 Disagree
3 Slightly disagree
4 Neither agree nor disagree
5 Slightly agree
6 Agree
7 Strongly agree
DK , RF

SLS_Q05

If I could live my life over, I would change almost nothing.
1 Strongly disagree
2 Disagree
3 Slightly disagree
4 Neither agree nor disagree
5 Slightly agree
6 Agree
7 Strongly agree
DK , RF

SLS_END

Cognition control (CGT)

CGT_BEG

Content block
External variables required:
PROXMODE: proxy identifier from the GR block.
FNAME: first name of respondent from household block.
DOCOG: do block flag from the sample file.
PE_Q01: first name of specific respondent from USU block
PE_Q02: last name of specific respondent from USU block
Screen display:
Display on header bar PE_Q01 and PE_Q02 separated by a space

CGT_C01

If DOCOG = 1, go to CGT_C02.
Otherwise, go to CGT_END.

CGT_C02

If PROXMODE = 1 (proxy interview), go to CGT_END.
Otherwise, go to CGT_N02.

CGT_N02

INTERVIEWER: The next module will be the Cognition component. Once completed, it will no longer be accessible.
Press <1> to continue.
Null, DK , RF are not allowed.

Note:

Once completed, the cognition module will no longer be accessible. If the cognition module is exited before completion then set CGT_N02 = Empty.

CGT_END

Cognition (COG)

COG_BEG

Content block
External variables required:
SEX_Q01: sex of specific respondent (1 = male, 2 = female) from Sex block
The start time for each question will be recorded in COG.adt
NOTES TO PROGRAMMER:
Save all information captured up until F10 is activated.
Display the following message once F10 is activated:
"Once you exit this module you can not re–enter.
Do you want to EXIT?
YES / NO"

COG_R01

Now, I am going to ask you to complete some tasks related to memory and concentration. Some of these tasks might seem difficult and some might seem easy, but that’s the way it is supposed to be. We don’t expect you to get them all right; we are asking everyone to do these tasks. It is very important that you are not disturbed during these tasks. Only you can complete these tasks, without help from anyone else or the use of an aid.
INTERVIEWER : Press <Enter> to continue.

COG_Q01

Would you like to complete these tasks in English or in French?
1 English
2 French
3 Unable to complete in either official language (Go to COG_END)
DK (Not allowed)
RF (Go to COG_END)

COG_E01

By selecting "Unable to complete in either official language" you will exit the Cognition module. Do you want to exit the module? Please confirm.

Note:

Trigger soft edit if COG_Q01 = 3.
Memory Test – First trial (REY, RAVLT) (Task # 1)

COG_Q02

To begin, a recorded voice will ask you a question that you will need to answer. Please listen carefully. Are you ready to listen to the recording?
1 Yes (Go to COG_R04)
2 No
DK , RF (Go to COG_END)

COG_N03

INTERVIEWER : If the respondent did not understand, repeat the instructions. (A recorded voice will ask you a question that you will need to answer. Please listen carefully. Are you ready to listen to the recording?)
1 Yes
2 No (Go to COG_N10)
( DK , RF are not allowed)

COG_R04

I will begin the recording now.
INTERVIEWER : ^DT_PLAYINST_E

Note:

Use DT_PLAYINST_E = "Press <F12> to play the recording.".
After <F12> is pressed use DT_PLAYINST_E = "Please wait…recording is now playing.".
When recording ends, go to COG_N04.
Use sound file "Hearingtest.wav".
Disable COG_R04 once done.

COG_N04

INTERVIEWER : Could the respondent clearly hear the recording?
1 Yes (Go to COG_Q07)
2 No
( DK , RF are not allowed)

COG_N05

INTERVIEWER : Adjust the volume.
Press <Enter> to continue.

COG_R05

I have adjusted the volume. I will replay the recording for you now.
INTERVIEWER : ^DT_PLAYINST_E

Note:

Use DT_PLAYINST_E = "Press <F12> to play the recording.".
After <F12> is pressed use DT_PLAYINST_E = "Please wait…recording is now playing.".
When recording ends, go to COG_N06.
Use sound file "Hearingtest.wav".
Disable COG_R05 once done.

COG_N06

INTERVIEWER : This time could the respondent clearly hear the recording?
1 Yes
2 No (Go to COG_N10)
( DK , RF are not allowed)

Note:

The following question, in addition to Question 31, contains the Auditory Verbal Learning Test word list used by Dr. Edith Meyer Taylor in "Psychological Appraisal of Children with Cerebral Defects", published by Harvard University Press (1954), originally developed by Dr. Andre Rey (1941). Harvard University Press granted permission to Statistics Canada for the use the word list in this survey.

COG_Q07

The first task will start with a recorded voice that will read you a list of words. We have purposely made the list long so it will be difficult for anyone to recall all of the words. Most people recall just a few words. Please listen carefully, as the list of words cannot be repeated. When the list of words is finished, I will ask you to recall aloud as many of the words as you can, in any order. May I start the recording?
1 Yes (Go to COG_R08)
2 No
( DK , RF are not allowed)

COG_N07

INTERVIEWER : If the respondent did not understand, repeat the instructions: (The first task will start with a recorded voice that will read you a list of words. We have purposely made the list long so it will be difficult for anyone to recall all of the words. Most people recall just a few words. Please listen carefully, as the list of words cannot be repeated. When the list of words is finished, I will ask you to recall aloud as many of the words as you can, in any order. May I start the recording?)
1 Yes
2 No (Go to COG_N10)
DK , RF (Go to COG_END)

COG_R08

I will begin the recording now.
INTERVIEWER : ^DT_PLAYWORD_E

Note:

Use DT_PLAYWORD_E = "Press <F12> to play the recording.".
After <F12> is pressed use DT_PLAYWORD_E = "Please wait…recording is now playing.".
When recording ends, go to COG_Q08.
Use sound file "Wordlist…wav".
Disable COG_R08 once done.

COG_Q08

Now, please tell me all the words you can remember in any order. Please begin.
INTERVIEWER : Press <F12> to start the timer.
Check all the words the respondent correctly recalls. Please use a space or a dash between each correct response.
To stop the timer, press <F12> if the respondent has finished before the allowed time.
When the timer has stopped, press <Enter> to continue.
01 Drum
02 Curtain
03 Bell
04 Coffee
05 School
06 Parent
07 Moon
08 Garden
09 Hat
10 Farmer
11 Nose
12 Turkey
13 Colour
14 House
15 River
( DK , RF are not allowed)
(Null is allowed)

Note:

Display count–down timer from 90 seconds.
Timer cannot be reset or paused, but can be stopped at any time. <F12> will stop the timer.
A beep will sound when timer completes.
Disable COG_Q08 once done.

COG_D08

If COG_Q08 = "null", fill COG_Q08 = 88.

Note:

At the time of the data processing, if COG_Q08 = "null", then the variable

COG_Q08

will be given a value of 88.

COG_R09

Thank you. This task is finished.
INTERVIEWER : Press <Enter> to continue.

COG_D10

not applicable

COG_N10

INTERVIEWER : Were there any factors that may have impaired the respondent's pe RF ormance on the test?
1 Yes
2 No (Go to COG_R12)
( DK , RF are not allowed)

COG_N11

INTERVIEWER : What were the factors?
Mark all that apply.
1 Had difficulty understanding English/French
2 Physical impairment, such as difficulty hearing
3 Distraction or noisy environment
4 Impaired concentration/memory problems
5 Used an aid
6 Technical difficulties with the laptop
7 Other – Specify (Go to COG_S11)
Go to COG_R12

COG_S11

INTERVIEWER : Specify. (80 spaces)
DK , RF

Note:

Consent to be recorded

COG_R12

For the next few tasks, we are going to ask you to name some items, as well as count numbers and letters out loud. To help us capture this information accurately, we would like your permission to make an audio recording of your responses. This recording will only be used by authorized Statistics Canada employees to code and verify your responses. It is subject to all of the same confidentiality provisions as other data collected by Statistics Canada under the Statistics Act.
INTERVIEWER : Press <Enter> to continue.

COG_Q12

Do you consent to be recorded?
1 Yes
2 No (Go to COG_END)
DK , RF (Go to COG_END)

Note:

Executive Function – Animals (SHARE) (Task # 2)

COG_Q13

Now, I would like you to name as many different animals as you can think of. You have one minute to do this. When you are ready to begin, I will start recording. Are you ready to begin?
1 Yes (Go to COG_Q14)
2 No
( DK , RF are not allowed)

COG_N13

INTERVIEWER : If the respondent did not understand, repeat the instructions. (Now, I would like you to name as many different animals as you can think of. You have one minute to do this. When you are ready to begin, I will start recording. Are you ready to begin?)
1 Yes
2 No (Go to COG_N16)
DK , RF (Go to COG_END)

COG_Q14

Please begin.
INTERVIEWER : ^DT_TIMEREC_E
If the respondent is silent for 15 seconds or stops before the end of the timer, encourage him or her by saying, "Can you think of any more animals?"
ONLY if the respondent asks for clarification, explain that animals include birds, insects, fish, etc. DO NOT help the respondent. Timer cannot be stopped.

Note:

Use DT_TIMEREC_E = "Press <F12> to start the timer and the recording."
When <F12> is pressed use DT_TIMEREC_E = "Please wait…Now recording."
The function <F12> starts the timer and recording.
Record for 60 seconds. Display count–down timer.
Timer cannot be reset and cannot be paused.
Once started, this question cannot be re–entered.
When the timer has stopped, go to COG_R15.
Disable COG_Q14 once done.

COG_R15

Thank you. This task is finished.
INTERVIEWER : Press <Enter> to continue.

COG_N16

INTERVIEWER : Were there any factors that may have impaired the respondent's pe RF ormance on the test?
1 Yes
2 No (Go to COG_Q18)
( DK , RF are not allowed)

COG_N17

INTERVIEWER : What were the factors?
Mark all that apply.
1 Had difficulty understanding English/French
2 Physical impairment, such as difficulty hearing
3 Distraction or noisy environment
4 Impaired concentration/memory problems
5 Used an aid
6 Technical difficulties with the laptop
7 Other – Specify (Go to COG_S17)
Go to COG_Q18

COG_S17

INTERVIEWER : Specify. (80 spaces)
DK , RF

Note:

Executive Function – Mental Alternation Test (E. Teng) (Task #3)
The following questions are the Mental Alteration Test (MAT ©) developed by Dr. Evelyn Teng (University of Southern California). The author granted permission to Statistics Canada for the use of the MAT in this survey.

COG_Q18

Now, I would like you to count from 1 to 20, such as 1, 2, 3, 4 and so on. Are you ready to begin?
1 Yes (Go to COG_Q19)
2 No
( DK , RF are not allowed)

COG_N18

INTERVIEWER : If the respondent did not understand, repeat the instructions. (Now, I would like you to count from 1 to 20, such as 1, 2, 3, 4 and so on. Are you ready to begin?)
1 Yes
2 No (Go to COG_N29)
DK , RF (Go to COG_END)

COG_Q19

Please begin.
INTERVIEWER : Press <F12> to start the timer and the recording.
Press <F12> when the respondent has successfully counted from 1 to 20.

Note:

Display count–up timer.
The timer can be stopped before reaching maximum of 30 seconds.
Once started, this question cannot be re–entered.
The timer cannot be either paused or reset.
A beep will sound when timer completes.
When the timer has stopped, go to COG_D20.
Disable COG_Q19 once done.

COG_D20

Record the time for COG_Q19.
Time in seconds
( MIN : 1) ( MAX : 30)
( DK , RF are not allowed)

COG_R21

Thank you. This task is finished.
INTERVIEWER : Press <Enter> to continue.

COG_Q22

Now, I would like you to say the alphabet, such as A, B, C, D and so on. Are you ready to begin?
1 Yes (Go to COG_Q23)
2 No
( DK , RF are not allowed)

COG_N22

INTERVIEWER : If the respondent did not understand, repeat the instructions. (Now, I would like you to say the alphabet, such as A, B, C, D and so on. Are you ready to begin?)
1 Yes
2 No (Go to COG_N29)
DK , RF (Go to COG_END)

COG_Q23

Please begin.
INTERVIEWER : Press <F12> to start the timer and the recording.
Press <F12> when the respondent has successfully recited from A to Z or to stop the timer.

Note:

Display count–up timer.
The timer can be stopped before reaching maximum of 30 seconds. Once started, this question cannot be re–entered. The timer cannot be either paused or reset. A beep will sound when timer completes. When the timer has stopped, go to COG_D24.
Disable COG_Q23 once done.

COG_D24

Record the time for COG_Q23.
Time in seconds
( MIN : 1) ( MAX : 30)
( DK , RF are not allowed)

COG_R25

Thank you. This task is finished.
INTERVIEWER : Press <Enter> to continue.

COG_Q26

Now, I would like you to alternate consecutive numbers, beginning with number 1, with the alphabet, beginning with the letter A, such as 1–A, 2–B, 3–C, 4–D, and so on. Are you ready to begin?
1 Yes (Go to COG_Q27)
2 No
DK , RF (Go to COG_END)

COG_N26

INTERVIEWER : If the respondent did not understand, repeat the instructions. (Now, I would like you to alternate consecutive numbers, beginning with number 1, with the alphabet, beginning with the letter A, such as 1–A, 2–B, 3–C, 4–D, and so on. Are you ready to begin?)
1 Yes
2 No (Go to COG_N29)
DK , RF (Go to COG_END)

COG_Q27

Please begin.
INTERVIEWER : Press <F12> to start the timer and the recording.
Timer cannot be stopped.

Note:

Display count–up timer. Allow 30 seconds precisely. Once started, this question cannot be re–entered. The timer cannot be either paused or reset. A beep will sound when timer completes.
When the timer has stopped, go to COG_R28.
Disable COG_Q27 once done.

COG_R28

Thank you. This is the end of the recording session.
INTERVIEWER : Press <Enter> to continue.

COG_N29

INTERVIEWER : Were there any factors that may have impaired the respondent’s pe RF ormance on the test?
1 Yes
2 No (Go to COG_C31)
( DK , RF are not allowed)

COG_N30

INTERVIEWER : What were the factors?
Mark all that apply.
1 Had difficulty understanding English/French
2 Physical impairment, such as difficulty hearing
3 Distraction or noisy environment
4 Impaired concentration/memory problems
5 Used an aid
6 Technical difficulties with the laptop
7 Other – Specify (Go to COG_S30)
Go to COG_C31

COG_S30

INTERVIEWER : Specify. 80 spaces)
DK , RF

Note:

Memory Test – Delay recall (REY, RAVLT) (Task # 4)

COG_C31

If COG_Q08 = Response, go to COG_Q31.
Otherwise, go to COG_END.

COG_Q31

A little while ago, a recorded voice read you a list of words and you repeated the ones you could remember. Please tell me any of the words that you can remember now.
INTERVIEWER : Press <F12> to start the timer.
Check all the words the respondent correctly recalls. Please use a space or a dash between each correct response.
Press <F12> when the respondent has finished before the allowed time.
01 Drum
02 Curtain
03 Bell
04 Coffee
05 School
06 Parent
07 Moon
08 Garden
09 Hat
10 Farmer
11 Nose
12 Turkey
13 Colour
14 House
15 River
( DK , RF are not allowed)
(Null is allowed)

Note:

Display count–down timer from 60 seconds. Timer cannot be reset or paused, but can be stopped at any time. <F12> will stop the timer. A beep will sound when timer completes.
When timer has stopped, continue to COG_R32.
At the time of the data processing, if COG_Q31 = "null", then the variable COG_Q31 will be given a value of 88.
Disable COG_Q31 once done.

COG_D31

If COG_Q31 = "null", then COG_Q31 = 88.

COG_R32

Thank you. This is the end of the tasks.
INTERVIEWER : Press <Enter> to continue.

COG_N33

INTERVIEWER : Were there any factors that may have impaired the respondent’s pe RF ormance on the task?
1 Yes
2 No (Go to COG_END)
( DK , RF are not allowed)

COG_N34

INTERVIEWER : What were the factors?
Mark all that apply.
1 Had difficulty understanding English/French
2 Physical impairment, such as difficulty hearing
3 Distraction or noisy environment
4 Impaired concentration/memory problems
5 Used an aid
6 Technical difficulties with the laptop
7 Other – Specify (Go to COG_S34)
Go to COG_END

COG_S34

INTERVIEWER : Specify. (80 spaces)
DK , RF

COG_END

Physical activities 2 (PA2)

PA2_BEG

This module is a modification of the Physical Activity Scale for the Elderly (PASE) © 1991 New England Research Institutes (NERI) (Massachusetts, United States). Statistics Canada is licensed to administer the PASE.
Content block
External variables required:
PE_Q01: first name of specific respondent from USU block
PE_Q02: last name of specific respondent from USU block
PROXMODE: proxy identifier from the GR block
FNAME: first name of respondent from household block
DOPA2: do block flag from the sample file
Screen display:
Display on header bar PE_Q01 and PE_Q02 separated by a space

PA2_C01A

If DOPA2 = 1, go to PA2_D01A.
Otherwise, go to PA2_END.

PA2_D01A

(not applicable)

PA2_R01A

(Please refer to page 2 of the booklet.)Now I’d like to ask you about ^YOUR2 level of physical activity. The following questions are about leisure activities, household activities, and work and volunteer activities done over the past 7 days. Some of these questions may not apply to ^YOU2 but we need to ask the same questions of everyone.
INTERVIEWER : Press <Enter> to continue.

Note:

Leisure time activity

PA2_Q01A

Over the past 7 days, how often did ^YOU1 participate in sitting activities such as reading, watching TV, computer activities or doing handicrafts?
INTERVIEWER : Read categories to respondent.
1 Never (Go to PA2_Q02A)
2 Seldom (1 to 2 days)
3 Sometimes (3 to 4 days)
4 Often (5 to 7 days)
DK , RF (Go to PA2_END)

PA2_Q01B

What were these activities?
INTERVIEWER : Mark all that apply.
01 Bingo, cards or other games
02 Computer activities
03 Crosswords, puzzles, etc.
04 Handicrafts
05 Listening to radio/music
06 Playing musical instruments
07 Reading
08 Visiting with others
09 Watching TV
10 Other – Specify (Go to PA2_S01B)

PA2_S01B

INTERVIEWER : Specify.
(80 spaces)
DK , RF

PA2_Q01C

On average, how many hours per day did ^YOU1 engage in these sitting activities?
INTERVIEWER : Read categories to respondent.
1 Less than 30 minutes
2 30 minutes but less than 1 hour
3 1 hour but less than 2 hours
4 2 hours but less than 4 hours
5 4 hours or more
DK , RF

PA2_Q02A

Over the past 7 days, how often did ^YOU1 take a walk outside ^YOUR1 home or yard for any reason? For example, for pleasure or exercise, walking to work, walking the dog, etc.
INTERVIEWER: Please do not include walking as part of gardening, golfing or any other sports, household and work related activities. Read categories to respondent.
1 Never (Go to PA2_Q03A)
2 Seldom (1 to 2 days)
3 Sometimes (3 to 4 days)
4 Often (5 to 7 days)
DK , RF (Go to PA2_Q03A)

PA2_Q02B

On average, how many hours per day did ^YOU1 spend walking?
INTERVIEWER : Read categories to respondent.
1 Less than 30 minutes
2 30 minutes but less than 1 hour
3 1 hour but less than 2 hours
4 2 hours but less than 4 hours
5 4 hours or more
DK , RF

PA2_Q03A

Over the past 7 days, how often did ^YOU1 engage in light sports or recreational activities such as bowling, golf with a cart, shuffleboard, badminton, fishing or other similar activities?
INTERVIEWER : Light sports or recreational activities refer to activities where you can easily have a conversation while engaged in the activity. Walking should be recorded in the previous question. Read categories to
1 Never (Go to PA2_Q04A)
2 Seldom (1 to 2 days)
3 Sometimes (3 to 4 days)
4 Often (5 to 7 days)
DK , RF (Go to PA2_Q04A)

PA2_Q03B

What were these activities?
INTERVIEWER : Mark all that apply.
01 Archery
02 Badminton
03 Billiards
04 Boating (canoeing, rowing, sailing)
05 Bocci
06 Bowling
07 Catch
08 Croquet
09 Darts
10 Fishing
11 Frisbee
12 Golf with a power cart
13 Horseshoes
14 Musical program
15 Rifle shooting
16 Shuffleboard
17 Swimming: no laps
18 Table tennis
19 Yoga or stretching
20 Other – Specify (Go to PA2_S03B)

PA2_S03B

INTERVIEWER : Specify.
(80 spaces)
DK , RF

PA2_Q03C

On average, how many hours per day did ^YOU1 engage in these light sports or recreational activities?
INTERVIEWER : Read categories to respondent.
1 Less than 30 minutes
2 30 minutes but less than 1 hour
3 1 hour but less than 2 hours
4 2 hours but less than 4 hours
5 4 hours or more
DK , RF

PA2_Q04A

Over the past 7 days, how often did ^YOU1 engage in moderate sports or recreational activities such as ballroom dancing, hunting, skating, golf without a cart, softball or other similar activities?
INTERVIEWER : Moderate sports or recreational activities refer to activities where there is a small increase in breathing while engaging in the activity. Please do not include gardening and lawn work.
Read categories to respondent.
1 Never (Go to PA2_Q05A)
2 Seldom (1 to 2 days)
3 Sometimes (3 to 4 days)
4 Often (5 to 7 days)
DK , RF (Go to PA2_Q05A)

PA2_Q04B

What were these activities?
INTERVIEWER : Mark all that apply.
01 Barn chores
02 Dancing (ballroom, ballet, disco)
03 Fencing
04 Football
05 Golf without a cart
06 Horseback riding
07 Hunting
08 Pilates or tai chi
09 Scuba diving or snorkelling
10 Skating (ice, roller)
11 Sledding / snowmobiling
12 Softball / baseball / cricket
13 Su RF ing / snowboarding
14 Tennis (doubles)
15 Trampoline
16 Volleyball
17 Other – Specify (Go to PA2_S04B)

PA2_S04B

INTERVIEWER : Specify.
(80 spaces)
DK , RF

PA2_Q04C

On average, how many hours per day did ^YOU1 engage in these moderate sports or recreational activities?
INTERVIEWER : Read categories to respondent.
1 Less than 30 minutes
2 30 minutes but less than 1 hour
3 1 hour but less than 2 hours
4 2 hours but less than 4 hours
5 4 hours or more
DK , RF

PA2_Q05A

Over the past 7 days, how often did ^YOU1 engage in strenuous sports or recreational activities such as jogging, swimming, snowshoeing, cycling, aerobics, skiing, or other similar activities?
INTERVIEWER : Strenuous sports or recreational activities refer to activities where having a conversation is very difficult.
Read categories to respondent.
1 Never (Go to PA2_Q06A)
2 Seldom (1 to 2 days)
3 Sometimes (3 to 4 days)
4 Often (5 to 7 days)
DK , RF (Go to PA2_Q06A)

PA2_Q05B

What were these activities?
INTERVIEWER : Mark all that apply.
01 Aerobic dance or water aerobics
02 Backpacking
03 Basketball
04 Bicycling / exercise bike
05 Board sailing
06 Handball / paddleball
07 Hiking
08 Hockey (ice or field)
09 Jogging
10 Lacrosse
11 Mountain climbing, running
12 Racquetball
13 Rope skipping
14 Rowing / canoeing for competition
15 Rowing machine
16 Skiing (cross country, downhill, water)
17 Snowshoeing
18 Soccer
19 Squash
20 Stair climbing
21 Swimming (with laps)
22 Tennis (single)
23 Other – Specify (Go to PA2_S05B)

PA2_S05B

INTERVIEWER : Specify.
(80 spaces)
DK , RF

PA2_Q05C

On average, how many hours per day did ^YOU1 engage in these strenuous sports or recreational activities?
INTERVIEWER : Read categories to respondent.
1 Less than 30 minutes
2 30 minutes but less than 1 hour
3 1 hour but less than 2 hours
4 2 hours but less than 4 hours
5 4 hours or more
DK , RF

PA2_Q06A

Over the past 7 days, how often did ^YOU1 do any exercises specifically to increase muscle strength and endurance, such as lifting weights or push–ups, etc.?
INTERVIEWER : Examples include hand weights, physical therapy with weights, callisthenics, sit–ups and weight lifting.
Read categories to respondent.
1 Never (Go to PA2_Q07)
2 Seldom (1 to 2 days)
3 Sometimes (3 to 4 days)
4 Often (5 to 7 days)
DK , RF (Go to PA2_Q07)

PA2_Q06B

What were these exercises?
INTERVIEWER : Mark all that apply.
1 Callisthenics
2 Push–ups
3 Sit–ups
4 Weight lifting and hand weights
5 Other – Specify (Go to PA2_S06B)

PA2_S06B

INTERVIEWER : Specify.
(80 spaces)
DK , RF

PA2_Q06C

On average, how many hours per day did ^YOU1 engage in exercises to increase muscle strength and endurance?
INTERVIEWER : Read categories to respondent.
1 Less than 30 minutes
2 30 minutes but less than 1 hour
3 1 hour but less than 2 hours
4 2 hours but less than 4 hours
5 4 hours or more
DK , RF

Note:

Household activity

PA2_Q07

During the past 7 days, ^HAVE ^YOU1 done any light housework, such as dusting or washing dishes?
INTERVIEWER : Examples include drying dishes, hanging up laundry, ironing, doing the laundry, meal preparation.
1 Yes
2 No
DK , RF

PA2_Q08

During the past 7 days, ^HAVE ^YOU1 done any heavy housework or chores such as vacuuming, scrubbing floors, washing windows or carrying wood?
INTERVIEWER : Examples include mopping floors, moving furniture, sweeping, washing walls, washing a car.
1 Yes
2 No
DK , RF

PA2_Q09A

During the past 7 days, did ^YOU1 engage in any of the following activities:
…home repairs like painting, wallpapering, electrical work, etc.?
1 Yes
2 No
DK , RF

PA2_Q09B

(During the past 7 days, did ^YOU1 engage in any of the following activities:)
…lawn work or yard care, including snow or leaf removal, wood chopping, etc. (excluding outdoor gardening)?
1 Yes
2 No
DK , RF

PA2_Q09C

(During the past 7 days, did ^YOU1 engage in any of the following activities:)
…outdoor gardening, sweeping the balcony or the stairs?
1 Yes
2 No
DK , RF

PA2_Q09D

(During the past 7 days, did ^YOU1 engage in any of the following activities:)
…caring for another person, such as children, a dependent spouse or other adult?
1 Yes
2 No
DK , RF

Note:

Work–related activity

PA2_Q10A

During the past 7 days, did ^YOU1 work for pay or as a volunteer?
1 Yes
2 No (Go to PA2_Q11A)
DK , RF (Go to PA2_Q11A)

PA2_Q10B

During the past 7 days, how many hours did ^YOU1 work for pay or as a volunteer?
INTERVIEWER : Enter amount only.
Hours
( MIN : 1) ( MAX : 120; warning after 50)
DK , RF

PA2_E10B

The entered value seems high. Please verify.

Note:

Trigger soft edit if PA2_Q10B > 50.

PA2_Q10C

Which of the following categories best describes the amount of physical activity required on ^YOUR1 job or as a volunteer?
INTERVIEWER : Read categories to respondent. 50 lbs is approximately 23kg.
1 Mainly sitting with slight arm movements (such as office worker or bus driver)
2 Sitting and standing with some walking (such as cashier or light tool and machinery worker)
3 Walking, with some handling of materials generally weighing less than 50 lbs (such as postal worker, waitress or construction worker)
4 Walking and heavy manual work often requiring handling of materials weighing over 50 lbs (such as lumberjack, stone mason, farm or general labourer)
DK , RF

Note:

Past year

PA2_Q11A

We just talked about ^YOUR2 activities during the last 7 days. Taking them altogether, would you say they represent the level of ^YOUR1 routine activity over the last 12 months?
INTERVIEWER : Read categories to respondent.
1 Strongly agree (Go to PA2_C12)
2 Agree (Go to PA2_C12)
3 Neither agree nor disagree (Go to PA2_C12)
4 Disagree
5 Strongly disagree
DK , RF (Go to PA2_C12)

PA2_Q11B

During the past 7 days, would you say that ^YOUR1 physical activity level was:
INTERVIEWER : Read categories to respondent.
1 …a lot lower than usual?
2 …a little lower than usual?
3 …a little higher than usual?
4 …a lot higher than usual?
DK , RF

PA2_C12

If PROXMODE = 1, go to PA2_END.
Otherwise, go to PA2_Q12.

PA2_Q12

In the past 12 months, ^HAVE ^YOU2 felt like ^YOU1 wanted to participate more in physical activities?
1 Yes
2 No (Go to PA2_END)
DK , RF (Go to PA2_END)

PA2_D13A

If PA2_Q02A = 1 and PA2_Q03A = 1 and PA2_Q04A = 1 and PA2_Q05A = 1 and PA2_Q06A = 1, DT_SPORTRECE = "physical activities".
Otherwise, DT_SPORTRECE = "more physical activities".

PA2_Q13

What prevented ^HIMHER from doing ^DT_SPORTRECE?
INTERVIEWER : Mark all that apply.
01 Cost
02 Transportation problems
03 Activities not available in the area
04 Location not physically accessible
05 Location is too far
06 Health condition limitation
07 Illness/injury
08 Fear of injury
09 Lack of time
10 Lack of energy
11 Lack of motivation
12 Lack of skills or knowledge
13 Other – Specify (Go to PA2_S13)
DK , RF
Go to PA2_END

PA2_S13

INTERVIEWER : Specify.
(80 spaces)
DK , RF

PA2_END

Nutritional risk (NUR)

NUR_BEG

Content block
External variables required:
PE_Q01: first name of specific respondent from USU block
PE_Q02: last name of specific respondent from USU block
PROXMODE: proxy identifier from the GR block.
FNAME: first name of respondent from household block
DONUR: do block flag from the sample file
Screen display:
Display on header bar PE_Q01 and PE_Q02 separated by a space

NUR_C01A

If DONUR=1, go to NUR_C01B.
Otherwise, go to NUR_END.

NUR_C01B

If PROXMODE = 1, go to NUR_END.
Otherwise, go to NUR_R01.

NUR_R01

Now, some questions about your weight and eating habits on a typical day.
INTERVIEWER : Press <Enter> to continue.

NUR_Q01

Compared with 6 months ago, have you gained weight, lost weight or stayed about the same?
INTERVIEWER : Interested in a gain or loss of 5 lbs (2.3 kilos) or more.
1 Gained weight
2 Lost weight
3 Stayed about the same (Go to NUR_Q03)
DK , RF (Go to NUR_Q03)

NUR_D02

If NUR_Q01 = 1, LOSEGAIN = "gain".
Otherwise, LOSEGAIN = "lose".

NUR_Q02

How much weight did you ^LOSEGAIN in the past 6 months?
INTERVIEWER : Read categories to respondent.
1 More than 10 pounds (More than 4.5 kilos)
2 6 to 10 pounds (2.7 to 4.5 kilos)
3 About 5 pounds (About 2.3 kilos)
4 Less than 5 pounds (Less than 2.3 kilos)
DK , RF

NUR_Q03

In general, how often do you skip meals?
INTERVIEWER : Read categories to respondent.
1 Almost every day
2 Often
3 Sometimes
4 Never or rarely
DK , RF

NUR_C04

If NUR_Q01 = DK , RF and NUR_Q03 = DK , RF , go to NUR_END.
Otherwise, go to NUR_Q04.

NUR_Q04

In general, how would you describe your appetite?
INTERVIEWER : Read categories to respondent.
1 Very good
2 Good
3 Fair
4 Poor
DK , RF

NUR_Q05

In general, how often do you cough, choke or have pain when swallowing food or fluid?
INTERVIEWER : Read categories to respondent.
1 Often or always
2 Sometimes
3 Rarely
4 Never
DK , RF

NUR_Q06

In general, how many servings of fruits and vegetables do you eat in a day?
INTERVIEWER : Fruits and vegetables can be canned, fresh, frozen or 100% natural juice. A serving is 125 ml (1/2 cup) of vegetables, 125 ml (1/2 cup) of cooked leafy vegetables, 250 ml (1 cup) raw leafy vegetables, 1 fruit or 125 ml (1/2 cup) of frozen or canned fruit or 125 ml (1/2 cup) of 100% natural juice.
1 Seven or more
2 Six
3 Five
4 Four
5 Three
6 Two
7 Less than two
DK , RF

NUR_Q07

How much fluid do you drink in a day?
INTERVIEWER : Includes water, tea, coffee, herbal drinks, 100% natural juices, fruit flavored drinks, milk and soft drinks but not alcohol. A cup is 250 ml.
Read categories to respondent.
1 Eight or more cups
2 Five to seven cups
3 Three to four cups
4 About two cups
5 Less than two cups
DK , RF

NUR_Q08

How often do you eat at least one meal each day with someone?
INTERVIEWER : Read categories to respondent.
1 Almost always
2 Often
3 Sometimes
4 Never or rarely
DK , RF

NUR_Q09

Do you usually cook your own meals?
INTERVIEWER : Includes fresh, frozen, pre–packaged and canned food.
1 Yes
2 No (Go to NUR_Q11)
DK , RF (Go to NUR_END)

NUR_Q10

Which of the following statements best describes meal preparation for you?
INTERVIEWER : Read categories to respondent.
1 I enjoy cooking most of my meals
2 I sometimes find cooking a chore
3 I usually find cooking a chore
DK , RF
Go to NUR_END

NUR_Q11

Which of the following statements best describes the meals prepared for you?
INTERVIEWER : Includes family members, friends and meal services.
Read categories to respondent.
1 I’m satisfied with the quality of the food prepared by others
2 I’m not satisfied with the quality of the food prepared by others
DK , RF

NUR_END

Oral health 3 (OH3)

OH3_BEG

Content block
External variables required:
PROXMODE: proxy identifier from the GR block
FNAME: first name of respondent from household block
DOOH3: do block flag from the sample file
REFDATE: current date from operating system
PE_Q01 : first name of specific respondent from USU block
PE_Q02 : last name of specific respondent from USU block
Screen display:
Display on header bar PE_Q01 and PE_Q02 separated by a space

OH3_C01

If DOOH3 = 1, go to OH3_D01.
Otherwise, go to OH3 _END.

OH3_D01

(not applicable)

OH3_R01

Next, some questions about the health of ^YOUR2 mouth, including ^YOUR1 teeth or dentures, tongue, gums, lips and jaw joints.
INTERVIEWER : Press <Enter> to continue.

OH3_Q01

In general, would you say the health of ^YOUR2 mouth is:
INTERVIEWER : Read categories to respondent.
1 …excellent?
2 …very good?
3 …good?
4 …fair?
5 …poor?
DK , RF

OH3_Q02

^DOVERB_C ^YOU1 have one or more of ^YOUR1 own teeth?
1 Yes
2 No
DK , RF

OH3_Q03

^DOVERB_C ^YOU1 wear dentures or false teeth?
INTERVIEWER : Include false teeth, full or partial dentures if they are removable. Do not include implants that are permanent.
1 Yes
2 No
DK , RF

OH3_D04

YEARAGO = (REFDATE – 1 year)

Note:

Display YEARAGO as Month DD, YYYY, e.g. January 2, 2008.

OH3_Q04

In the past 12 months, that is, from ^YEARAGO to yesterday, how often ^HAVE ^YOU1 found it uncomfortable to eat any food because of problems with ^YOUR1 mouth?
INTERVIEWER : Read categories to respondent.
1 Often
2 Sometimes
3 Rarely
4 Never
DK , RF

OH3_Q05

In the past 12 months, that is, from ^YEARAGO to yesterday, how often ^HAVE ^YOU1 voided eating particular foods because of problems with ^YOUR1 mouth?
INTERVIEWER : Read categories to respondent.
1 Often
2 Sometimes
3 Rarely
4 Never
DK , RF

OH3_C05

If OH3_Q02 = 2 and OH3_Q03 = 2, go to OH3_Q09A.
Otherwise, go to OH3_D06.

OH3_D06

(not applicable)

OH3_Q06

Now a few questions about ^YOUR2 regular dental care habits.How often ^DOVERB ^YOU1 usually brush ^YOUR1 teeth and/or dentures? (For example: twice a day, three times a week, once a month.)
INTERVIEWER : Enter amount only.
Times
( MIN : 0) ( MAX : 500)
DK , RF

OH3_C06

If OH3_Q06 = 0, DK or RF , go to OH3_Q07.
Otherwise, go to OH3_N06.

OH3_N06

INTERVIEWER : Select the reporting period.
1 Per day
2 Per week
3 Per month
4 Per year
( DK , RF are not allowed)

OH3_E06

An unusual value has been entered. Please confirm.

Note:

Trigger soft edit if ((OH3_Q06 > 3 and OH3_N06 = 1) or (OH3_Q06 > 21 and OH3_N06 = 2) or (OH3_Q06 > 90 and OH3_N06 = 3)

OH3_Q07

How often ^DOVERB ^YOU1 usually floss ^YOUR1 teeth? (For example: twice a day, three times a week, once a month.)
INTERVIEWER : Enter amount only.
Times
( MIN : 0) ( MAX : 500)
DK , RF

OH3_C07

If OH3_Q07 = 0, DK or RF , go to OH3_Q09A.
Otherwise, go to OH3_N07.

OH3_N07

INTERVIEWER : Select the reporting period
1 Per day
2 Per week
3 Per month
4 Per year
DK , RF

OH3_E07

An unusual value has been entered. Please confirm.

Note:

Trigger soft edit if ((OH3_Q07 > 3 and OH3_N07 = 1) or (OH3_Q07 > 21 and OH3_N07 = 2) or (OH3_Q07 > 90 and OH3_N07 = 3)

OH3_Q09A

When was the last time ^YOU1 saw a dental professional?
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
7 Never
DK , RF (Go to OH3_Q10A)

OH3_C09A

If OH3_Q09A = 4 or OH3_Q09A = 5 or OH3_Q09A = 6 or OH3_Q09A = 7, go to OH3_Q09B.
Otherwise, go to OH3_Q10A.

OH3_Q09B

What are the reasons ^YOU2 ^HAVE not seen a dental professional in the past 3 years?
INTERVIEWER : Mark all that apply.
01 Have not gotten around to it
02 Respondent – did not think it was necessary
03 Dental professional – did not think it was necessary
04 Personal or family responsibilities
05 Not available – at time required
06 Not available – at all in the area
07 Waiting time was too long
08 Transportation – problems
09 Language – problem
10 Cost
11 Did not know where to go/uninformed
12 Fear (e.g. painful, embarrassing, find something wrong)
13 Wears dentures
14 Unable to leave house because of a health problem
15 Other – Specify (Go to OH3_S09B)
DK , RF
Go to OH3_Q10A

OH3_S09B

INTERVIEWER : Specify.
(80 spaces)
DK , RF

OH3_Q10A

^DOVERB_C ^YOU1 have insurance or a government program that covers all or part of ^YOUR1 dental expenses?
1 Yes
2 No (Go to OH3_END)
DK , RF (Go to OH3_END)

OH3_Q10B

Is it:
INTERVIEWER: Read categories to respondent. Mark all that apply.
1…an employer-sponsored plan?
2…a provincial program for seniors?
3…a private plan?
4…a government program for social service (welfare) clients?
5…a government program for First Nations and Inuit?
DK , RF

OH3_END

Medication use (MED)

MED_BEG

Content block
External variables required:
PE_Q01: first name of specific respondent from USU block
PE_Q02: last name of specific respondent from USU block
FNAME: first name of respondent from household component
REFDATE: current date from operating system
PROXMODE: proxy identifier from the GR block
DOMED: do block flag from the sample file
SEX_Q01: sex of specific respondent (1=male, 2=female) from SEX block
Screen display:
Display on header bar PE_Q01 and PE_Q02 separated by a space

MED_C1

If DOMED = 1, go to MED_R1.
Otherwise, go to MED_END.

MED_R1

Now I’d like to ask a few questions about ^YOUR2 use of medications, both prescription and over–the–counter.
INTERVIEWER : Press <Enter> to continue.

MED_D01A

MONTHAGO = (REFDATE – 1 MONTH)

Note:

Display month DD, YYYY eg. January 2, 2008

MED_Q1A

In the past month, that is, from ^MONTHAGO to yesterday, did ^YOU2 take
:…pain relievers such as Aspirin or Tylenol (including arthritis medicine and anti–inflammatories)?
1 Yes
2 No (Go to MED_Q1B)
DK , RF (Go to MED_END)

MED_Q1AA

Did ^YOU1 take it on a daily basis?
1 Yes
2 No
DK , RF

MED_Q1B

In the past month, that is, from ^MONTHAGO to yesterday, did ^YOU2 take:
…tranquilizers such as Valium or Ativan?
1 Yes
2 No (Go to MED_Q1C)
DK , RF (Go to MED_Q1C)

MED_Q1BB

Did ^YOU1 take it on a daily basis?
1 Yes
2 No
DK , RF

MED_Q1C

(In the past month, that is, from ^MONTHAGO to yesterday, did ^YOU2 take:)
…diet pills such as Dexatrim, Ponderal or Fastin?
1 Yes
2 No (Go to MED_Q1D)
DK , RF (Go to MED_Q1D)

MED_Q1CC

Did ^YOU1 take it on a daily basis?
1 Yes
2 No
DK , RF

MED_Q1D

(In the past month, that is, from ^MONTHAGO to yesterday, did ^YOU2 take:)
…anti–depressants such as Prozac, Paxil or Effexor?
1 Yes
2 No (Go to MED_Q1E)
DK , RF (Go to MED_Q1E)

MED_Q1DD

Did ^YOU1 take it on a daily basis?
1 Yes
2 No
DK , RF

MED_Q1E

(In the past month, that is, from ^MONTHAGO to yesterday, did ^YOU2 take:)
…codeine, Demerol or morphine?
1 Yes
2 No (Go to MED_Q1G)
DK , RF (Go to MED_Q1G)

MED_Q1EE

Did ^YOU1 take it on a daily basis?
1 Yes
2 No
DK , RF

MED_Q1G

(In the past month, that is, from ^MONTHAGO to yesterday, did ^YOU2 take:)
…asthma medications such as inhalers or nebulizers?
1 Yes
2 No (Go to MED_Q1I)
DK , RF (Go to MED_Q1I)

MED_Q1GG

Did ^YOU1 take it on a daily basis?
1 Yes
2 No
DK , RF

MED_Q1I

(In the past month, that is, from ^MONTHAGO to yesterday, did ^YOU2 take:)
…penicillin or other antibiotics?
1 Yes
2 No (Go to MED_Q1J)
DK , RF (Go to MED_Q1J)

MED_Q1II

Did ^YOU1 take it on a daily basis?
1 Yes
2 No
DK , RF

MED_Q1J

(In the past month, that is, from ^MONTHAGO to yesterday, did ^YOU2 take:)
…medicine for the heart?
1 Yes
2 No (Go to MED_Q1L)
DK , RF (Go to MED_Q1L)

MED_Q1JJ

Did ^YOU1 take it on a daily basis?
1 Yes
2 No
DK , RF

MED_Q1L

(In the past month, that is, from ^MONTHAGO to yesterday, did ^YOU2 take:)
…diuretics or water pills?
1 Yes
2 No (Go to MED_Q1M)
DK , RF (Go to MED_Q1M)

MED_Q1LL

Did ^YOU1 take it on a daily basis?
1 Yes
2 No
DK , RF

MED_Q1M

(In the past month, that is, from ^MONTHAGO to yesterday, did ^YOU2 take:)
…steroids?
1 Yes
2 No (Go to MED_Q1P)
DK , RF (Go to MED_Q1P)

MED_Q1MM

Did ^YOU1 take it on a daily basis?
1 Yes
2 No
DK , RF

MED_Q1P

(In the past month, that is, from ^MONTHAGO to yesterday, did ^YOU2 take:)
…sleeping pills such as Imovane, Nytol or Starnoc?
1 Yes
2 No (Go to MED_Q1Q)
DK , RF (Go to MED_Q1Q)

MED_Q1PP

Did ^YOU1 take it on a daily basis?
1 Yes
2 No
DK , RF

MED_Q1Q

(In the past month, that is, from ^MONTHAGO to yesterday, did ^YOU2 take:)
…stomach remedies?
1 Yes
2 No (Go to MED_Q1R)
DK , RF (Go to MED_Q1R)

MED_Q1QQ

Did ^YOU1 take it on a daily basis?
1 Yes
2 No
DK , RF

MED_Q1R

(In the past month, that is, from ^MONTHAGO to yesterday, did ^YOU2 take:)
…laxatives?
1 Yes
2 No (Go to MED_C1T)
DK , RF (Go to MED_C1T)

MED_Q1RR

Did ^YOU1 take it on a daily basis?
1 Yes
2 No
DK , RF

MED_C1T

If SEX_Q01 = 2, go to MED_Q1T.
Otherwise, go to MED_Q1U.

MED_Q1T

(In the past month, that is, from ^MONTHAGO to yesterday, did ^YOU2 take:)
…hormones for menopause or aging symptoms?
1 Yes
2 No (Go to MED_Q1U)
DK , RF (Go to MED_Q1U)

 

MED_Q1TTDid ^YOU1 take it on a daily basis?
1 Yes
2 No
DK , RF

MED_Q1U

(In the past month, that is, from ^MONTHAGO to yesterday, did ^YOU2 take:)
…thyroid medication such as Synthroid or Levothyroxine?
1 Yes
2 No (Go to MED_Q1V)
DK , RF (Go to MED_Q1V)

MET_Q1UU

Did ^YOU1 take it on a daily basis?
1 Yes
2 No
DK , RF

MED_Q1V

(In the past month, that is, from ^MONTHAGO to yesterday, did ^YOU2 take:)
…any other medication?
1 Yes – Specify
2 No (Go to MED_END)
DK , RF (Go to MED_END)

MED_S1V

INTERVIEWER : Specify.
(80 spaces)
DK , RF

MED_Q1VV

Did ^YOU1 take it on a daily basis?
1 Yes
2 No
DK , RF

MED_END

Dietary supplement use – vitamins and minerals (DS2)

DS2_BEG

Content block
External variables required:
PROXMODE: proxy identifier from the GR block
FNAME: first name of respondent from household block
DODS2: do block flag from the sample file
PE_Q01: first name of specific respondent from USU block
PE_Q02: last name of specific respondent from USU block
Screen display:
Display on header bar PE_Q01 and PE_Q02 separated by a space

DS2_C01

If DODS2 = 1, go to DS2_R01.
Otherwise, go to DS2_END.

DS2_R01

Now, some questions about ^YOUR2 use of nutritional supplements in the past month.
INTERVIEWER : Press <Enter> to continue.

DS2_Q01

In the past month, how often did ^YOU1 take multivitamin supplements?
INTERVIEWER : Read categories to respondent.
1 Every day
2 A few times a week
3 Once a week
4 Less than once a week
5 Never
DK , RF (Go to DS2_END)

DS2_D02

If DS2_Q01 = (1, 2, 3, 4), DT_SUPPERE = "other than what is included in ^YOUR1
multivitamin?".
Otherwise, DT_SUPPERE = "?".

DS2_Q02

In the past month, how often did ^YOU1 take calcium supplements ^DT_SUPPERE
INTERVIEWER : Read categories to respondent.
1 Every day
2 A few times a week
3 Once a week
4 Less than once a week
5 Never
DK , RF

DS2_Q03

In the past month, how often did ^YOU1 take vitamin D supplements ^DT_SUPPERE?
INTERVIEWER : Read categories to respondent.
1 Every day
2 A few times a week
3 Once a week
4 Less than once a week
5 Never
DK , RF

DS2_Q04

In the past month, how often did ^YOU1 take vitamin B12 supplements ^DT_SUPPERE?
INTERVIEWER : Read categories to respondent.
1 Every day
2 A few times a week
3 Once a week
4 Less than once a week
5 Never
DK , RF

DS2_END

Smoking (SMK)

SMK_BEG

Content block
External variables required:
PROXMODE: proxy identifier from the GR block.
FNAME: first name of respondent from household block.
PE_Q01: first name of specific respondent from USU block
PE_Q02: last name of specific respondent from USU block
DOSMK: do block flag from the sample file.
CURRAGE: current age of respondent from AN2 block.

SMK_C1

If (DOSMK = 2), go to SMK_END.
Otherwise, go to SMK_R1.

SMK_R1

The next questions are about smoking.
INTERVIEWER : Press <Enter> to continue.

SMK_Q201A

In ^YOUR1 lifetime, ^HAVE ^YOU2 smoked a total of 100 or more cigarettes (about 4 packs)?
1 Yes (Go to SMK_Q201C)
2 No
DK , RF

SMK_Q201B

^HAVE_C ^YOU1 ever smoked a whole cigarette?
1 Yes (Go to SMK_Q201C)
2 No (Go to SMK_Q202)
DK (Go to SMK_Q202)
RF

SMK_C201C

If SMK_Q201A = RF and SMK_Q201B = RF , go to SMK_END.
Otherwise, go to SMK_Q202.

SMK_Q201C

At what age did ^YOU1 smoke ^YOUR1 first whole cigarette?
INTERVIEWER : minimum is 5; maximum is ^CURRAGE.
Age in years
( MIN : 5) ( MAX : ^CURRAGE)
DK , RF

SMK_E201C

The entered age at which the respondent first smoked a whole cigarette is invalid.
Please return and correct.

Note:

Trigger hard edit if SMK_Q201C < 5 or SMK_Q201C > CURRAGE.

SMK_Q202

At the present time, ^DOVERB ^YOU2 smoke cigarettes daily, occasionally or not at all?
1 Daily
2 Occasionally (Go to SMK_Q205B)
3 Not at all (Go to SMK_C205D)
DK , RF (Go to SMK_END)

Note:

Daily smoker (current)

SMK_Q203

At what age did ^YOU1 begin to smoke cigarettes daily?
INTERVIEWER : minimum is 5; maximum is ^CURRAGE.
Age in years
( MIN : 5) ( MAX : ^CURRAGE)
DK , RF

SMK_E203A

The entered age at which the respondent first began to smoke cigarettes daily is invalid. Please return and correct.

Note:

Trigger hard edit if SMK_Q203 < 5 or SMK_Q203 > CURRAGE.

SMK_E203B

The respondent has indicated that they began smoking cigarettes daily at a younger age than when they smoked their first whole cigarette. Please confirm.

Note:

Trigger soft edit if SMK_Q201C > SMK_Q203.

SMK_Q204

How many cigarettes ^DOVERB ^YOU1 smoke each day now?
Cigarettes
( MIN : 1) ( MAX : 99 Warning after 60)
DK , RF
Go to SMK_END

Note:

Occasional smoker (current)

SMK_Q205B

On the days that ^YOU2 ^DOVERB smoke, how many cigarettes ^DOVERB ^YOU1 usually smoke?
Cigarettes
( MIN : 1) ( MAX : 99 ; warning after 60)
DK , RF

SMK_Q205C

In the past month, on how many days ^HAVE ^YOU1 smoked 1 or more cigarettes?
Days
( MIN : 0) ( MAX : 30)
DK , RF

Note:

Occasional smoker or non–smoker (current)

SMK_E205C

The respondent has previously indicated that they smoke cigarettes occasionally, but that they have smoked every day for the past month. Please verify.

Note:

Trigger soft edit if SMK_Q202 = 2 and SMK_Q205C = 30.

SMK_C205D

If SMK_Q201A <> 1 (has not smoked 100 or more cigarettes lifetime), go to SMK_END.
Otherwise, go to SMK_Q205D.

SMK_Q205D

^HAVE_C ^YOU1 ever smoked cigarettes daily?
1 Yes (Go to SMK_Q207)
2 No
DK , RF (Go to SMK_END)

Note:

Occasional or non–smoker (current) – Daily smoker (previously)

SMK_C206A

If SMK_Q202 = 2 (current occasional smoker), go to SMK_END.
Otherwise, go to SMK_Q206A.

SMK_Q206A

When did ^YOU1 stop smoking? Was it:
INTERVIEWER : Read categories to respondent.
1 …less than one year ago?
2 …1 year to less than 2 years ago? (Go to SMK_END)
3 …2 years to less than 3 years ago? (Go to SMK_END)
4 …3 or more years ago? (Go to SMK_Q206C)
DK , RF (Go to SMK_END)

SMK_Q206B

In what month did ^YOU1 stop?
01 January
02 February
03 March
04 April
05 May
06 June
07 July
08 August
09 September
10 October
11 November
12 December
DK , RF
Go to SMK_END

SMK_D206C

CURRAGES = CURRAGE – 5

SMK_Q206C

How many years ago was it?
INTERVIEWER : minimum is 3; maximum is ^CURRAGES.
Years
( MIN : 3) ( MAX : ^CURRAGES)
DK , RF
Go to SMK_END

SMK_E206C

The number of years ago that the respondent stopped smoking is invalid.
Please return and correct.

Note:

Trigger hard edit if SMK_Q206C < 3 or SMK_Q206C > CURRAGES.

SMK_Q207

At what age did ^YOU1 begin to smoke (cigarettes) daily?
INTERVIEWER : minimum is 5; maximum is ^CURRAGE.
Age in years
( MIN : 5) ( MAX : ^CURRAGE)
DK , RF

SMK_E207A

The entered age at which the respondent first began to smoke cigarettes daily is invalid.
Please return and correct.

Note:

Trigger hard edit if SMK_Q207 < 5 or SMK_Q207 > CURRAGE.

SMK_E207B

The respondent has indicated that they began smoking cigarettes daily at a younger age than when they smoked their first whole cigarette. Please confirm.

Note:

Trigger soft edit if SMK_Q201C > SMK_Q207.

SMK_Q208

How many cigarettes did ^YOU1 usually smoke each day?
Cigarettes
( MIN : 1) ( MAX : 99 ; warning after 60)
DK , RF

SMK_Q209A

When did ^YOU1 stop smoking daily? Was it:
INTERVIEWER : Read categories to respondent.
1 …less than one year ago?
2 …1 year to less than 2 years ago? (Go to SMK_C210)
3 …2 years to less than 3 years ago? (Go to SMK_C210)
4 …3 or more years ago? (Go to SMK_Q209C)
DK , RF (Go to SMK_END)

SMK_Q209B

In what month did ^YOU1 stop?
01 January
02 February
03 March
04 April
05 May
06 June
07 July
08 August
09 September
10 October
11 November
12 December
DK , RF
Go to SMK_C210

SMK_Q209C

How many years ago was it?
INTERVIEWER : minimum is 3; maximum is ^CURRAGES.
Years
( MIN : 3) ( MAX : ^CURRAGES)
DK , RF

SMK_E209C

The number of years ago that the respondent stopped smoking daily is invalid.
Please return and correct.

Note:

Trigger hard edit if SMK_Q209C < 3 or (SMK_Q209C > CURRAGES).

SMK_E209D

The number of years ago that the respondent stopped smoking daily is invalid.
Please return and correct.

Note:

Trigger hard edit if SMK_Q207 > (CURRAGE – SMK_Q209C).

SMK_C210

If SMK_Q202 = 2 (current occasional smoker), go to SMK_END.
Otherwise, go to SMK_Q210A.

SMK_Q210A

Was that when ^YOU1 completely quit smoking?
1 Yes (Go to SMK_END)
2 No
DK , RF (Go to SMK_END)

SMK_Q210B

When did ^YOU1 stop smoking completely? Was it:
INTERVIEWER : Read categories to respondent.
1 …less than one year ago?
2 …1 year to less than 2 years ago? (Go to SMK_END)
3 …2 years to less than 3 years ago? (Go to SMK_END)
4 …3 or more years ago? (Go to SMK_Q210D)
DK , RF (Go to SMK_END)

SMK_E210B

The number of years ago that the respondent quit smoking completely is greater than the number of years ago the respondent stopped smoking daily. Please verify.

Note:

Trigger soft edit if SMK_Q209A < SMK_Q210B.

SMK_Q210C

In what month did ^YOU1 stop?
01 January
02 February
03 March
04 April
05 May
06 June
07 July
08 August
09 September
10 October
11 November
12 December
DK , RF
Go to SMK_END

SMK_Q210D

How many years ago was it?
INTERVIEWER : minimum is 3; maximum is ^CURRAGES.
Years
( MIN : 3) ( MAX : ^CURRAGES)
DK , RF

SMK_E210D

The number of years ago that the respondent completely stopped smoking is invalid.
Please return and correct.

Note:

Trigger hard edit if SMK_Q210D < 3 or (SMK_Q210D > CURRAGES).

SMK_END

Alcohol use (ALC)

ALC_BEG

Content block
External variables required:
PROXMODE: proxy identifier from the GR block
FNAME: first name of selected respondent
DOALC: do block flag from the sample file
REFDATE: current date from operating system

ALC_C01

If DOALC=1, go to ALC_D01A.
Otherwise, go to ALC_END.

ALC_D01A

(not applicable)

ALC_D01B

YEARAGO = REFDATE – one year.

Note:

Display YEARAGO as Month DD, YYYY, e.g. January 2, 2008.

ALC_R01

Now, some questions about ^YOUR2 alcohol consumption.When we use the word ‘drink’ it means: – one bottle or can of beer or a glass of draft– one glass of wine or a wine cooler– one drink or cocktail with 1 and a 1/2 ounces of liquor
INTERVIEWER : Press <Enter> to continue.

ALC_Q01

During the past 12 months, that is, from ^YEARAGO to yesterday, ^HAVE ^YOU2 had a drink of beer, wine, liquor or any other alcoholic beverage?
1 Yes
2 No (Go to ALC_Q05B)
DK , RF (Go to ALC_END)

ALC_Q02

During the past 12 months, how often did ^YOU1 drink alcoholic beverages?
1 Less than once a month
2 Once a month
3 2 to 3 times a month
4 Once a week
5 2 to 3 times a week
6 4 to 6 times a week
7 Every day
DK , RF

ALC_Q03

How often in the past 12 months, ^HAVE ^YOU1 had 5 or more drinks on one occasion?
1 Never
2 Less than once a month
3 Once a month
4 2 to 3 times a month
5 Once a week
6 More than once a week
DK , RF
Go to ALC_END

ALC_Q05B

^HAVE_C ^YOU1 ever had a drink?
1 Yes
2 No
DK , RF

ALC_END

Changes made to improve health (CIH)

CIH_BEG

Content block
External variables required:
PROXMODE: proxy identifier, from the GR block
FNAME: first name of respondent from household block
DOCIH: do block flag, from the sample file
PE_Q01 : first name of specific respondent from USU block
PE_Q02 : last name of specific respondent from USU block
Screen display:
Display on header bar PE_Q01 and PE_Q02 separated by a space

CIH_C1A

If DOCIH = 1, go to CIH_C1B.
Otherwise, go to CIH_END.

CIH_C1B

If PROXMODE = 1, go to CIH_END.
Otherwise, go to CIH_Q1.

CIH_Q1

Next, some questions about changes made to improve health. In the past 12 months, did you do anything to improve your health? (For example, lost weight, quit smoking, increased exercise)
1 Yes
2 No (Go to CIH_Q3)
DK , RF (Go to CIH_END)

CIH_Q2

What is the single most important change you have made?
1 Increased exercise, sports / physical activity
2 Lost weight
3 Changed diet / improved eating habits
4 Quit smoking / reduced amount smoked
5 Drank less alcohol
6 Reduced stress level
7 Received medical treatment
8 Took vitamins
9 Other
DK , RF

CIH_D3

If CIH_Q1 = 1, DT_ANYTHING = "anything else".
Otherwise, DT_ANYTHING = "anything".

CIH_Q3

Do you think there is ^DT_ANYTHING you should do to improve your physical health?
1 Yes
2 No (Go to CIH_END)
DK , RF (Go to CIH_END)

CIH_Q4

What is the most important thing?
1 Start / Increase exercise, sports / physical activity
2 Lose weight
3 Change diet / improve eating habits
4 Quit smoking / reduce amount smoked
5 Drink less alcohol
6 Reduce stress level
7 Receive medical treatment
8 Take vitamins
9 Other
DK , RF

CIH_Q5

Is there anything stopping you from making this improvement?
1 Yes
2 No (Go to CIH_Q7)
DK , RF (Go to CIH_Q7)

CIH_Q6

What is that?
INTERVIEWER : Mark all that apply.
01 Lack of will power / self–discipline
02 Family responsibilities
03 Work schedule
04 Addiction to drugs / alcohol
05 Physical condition
06 Disability / health problem
07 Too stressed
08 Too costly / financial constraints
09 Not available – in area
10 Transportation problems
11 Weather problems
12 Other
DK , RF

CIH_Q7

Is there anything you intend to do to improve your physical health in the next year?
1 Yes
2 No (Go to CIH_END)
DK , RF (Go to CIH_END)

CIH_Q8

What is that?
INTERVIEWER : Mark all that apply.
1 Start / Increase exercise, sports / physical activity
2 Lose weight
3 Change diet / improve eating habits
4 Quit smoking / reduce amount smoked
5 Drink less alcohol
6 Reduce stress level
7 Receive medical treatment
8 Take vitamins
9 Other
DK , RF

CIH_END

Falls (FAL)

FAL_BEG

Content block
External variables required:
PROXMODE: proxy identifier, from the GR block
FNAME: first name of respondent from household component
DOFAL: do block flag, from the sample file
CURRAGE: Age of respondent from AN2 component

FAL_C01A

If DOFAL=1, go to FAL_C01B.
Otherwise, go to FAL _END.

FAL_C01B

If CURRAGE >= 65, go to FAL_R01.
Otherwise, go to FAL_END.

FAL_R01

Now some questions about falls that ^YOU2 may have experienced. We are interested in falls where ^YOU1 hurt ^YOURSELF enough to limit some of ^YOUR1 normal activities.
INTERVIEWER : Press <Enter> to continue.

FAL_Q01

In the past 12 months, did ^YOU1 have any falls?
1 Yes
2 No (Go to FAL_Q10)
DK , RF (Go to FAL_Q10)

FAL_Q02

How many times ^HAVE ^YOU1 fallen in the past 12 months?
Times
( MIN : 1) ( MAX : 30 ; warning after 10)
DK , RF

FAL_E02

An unusual amount has been entered. Please verify.

Note:

Trigger soft edit if FAL_Q02 > 10.

FAL_Q03

What has been ^YOUR1 most serious injury or problem due to a fall within the past 12 months?
INTERVIEWER : Read categories to respondent.
01 No serious injury (Go to FAL_Q09)
02 Sprain/strain
03 Bruises
04 Cuts
05 Discomfort
06 Fracture of hip
07 Fracture of leg
08 Fracture of arm or wrist
09 Fracture of back/vertebra
10 Head injury
11 Other – Specify (Go to FAL_S03)
DK , RF (Go to FAL_Q10)
Go to FAL_Q04A

FAL_S03

INTERVIEWER : Specify.
(80 spaces)
DK , RF

FAL_Q04A

Did ^YOU1 receive any medical attention from a health professional within 48 hours following this injury?
1 Yes
2 No (Go to FAL_Q05)
DK , RF (Go to FAL_Q05)

FAL_Q04B

^WERE_C ^YOU1 hospitalized for this injury?
1 Yes
2 No
DK , RF

FAL_Q05

When did ^YOUR1 fall happen? Was it:
INTERVIEWER : Read categories to respondent.
1 … less than one month ago?
2 … 1 month to less than 3 months ago?
3 … 3 months to less than 6 months ago?
4 … 6 or more months ago?
DK , RF

FAL_Q06

How did ^YOUR1 fall happen?
INTERVIEWER : Read categories to respondent.
1 Tripped, stumbled or fell while standing or walking
2 Fell while exercising (except walking)
3 Fell from height of greater than 1 meter or 3 feet (for example, ladder, tree, roof)
4 Fell from furniture (for example, bed, chair)
5 Slipped in bathtub
6 Other – Specify (Go to FAL_S06)
DK , RF
Go to FAL_Q07

FAL_S06

INTERVIEWER : Specify.
(80 spaces)
DK , RF

FAL_Q07

Where did this fall happen?
INTERVIEWER : Read categories to respondent.
1 Inside of ^YOUR1 home
2 Outside of ^YOUR1 home, but inside a building
3 Outdoors (Go to FAL_Q08)
DK , RF
Go to FAL_Q09

FAL_Q08

Was snow or ice a factor in ^YOUR1 fall?
1 Yes
2 No
DK , RF

FAL_Q09

^WERE_C ^YOU1 using an assistive device (for example, walker, wheelchair, cane or leg brace) at the time of ^YOUR1 fall?
1 Yes
2 No
DK , RF

FAL_D10

If FAL_Q01 = 2, FALLPERIODE = " that occurred more than a year ago?".
Otherwise, FALLPERIODE = "?".

FAL_Q10

At the present time, ^ARE ^YOU1 getting follow–up care from a health professional because of an injury caused by a fall^FALLPERIODE
1 Yes
2 No
DK , RF

FAL_D11

(not applicable)

FAL_Q11

^ARE_C ^YOU1 worried or concerned that in the future ^YOU1 might fall?
1 Yes
2 No (Go to FAL_END)
DK , RF (Go to FAL_END)

FAL_Q12

As a result of this concern, ^HAVE ^YOU1 stopped doing some things ^YOU1 used to do or liked to do?
1 Yes
2 No
DK , RF

FAL_END

Instrumental activities of daily living (IAL)

IAL_BEG

This module is a modification of the activities of daily living questions of the OARS Multidimensional Assessment Questionnaire© developed by Dr. Gerda G. Fillenbaum (Duke University Medical Center). The author granted permission to Statistics Canada for the use of the activities of daily living questions in this survey.
External variables required:
PROXMODE: proxy identifier from the GR block
FNAME: first name of respondent
DOIAL : do block flag from the sample file
PE_Q01 : first name of specific respondent from USU block
PE_Q02 : last name of specific respondent from USU block
Screen display:
Display on header bar PE_Q01 and PE_Q02 separated by a space

IAL_C01

If (DOIAL=1), go to IAL_R01.
Otherwise, go to IAL_END.

IAL_R01

Now I’d like to ask you about some activities of daily living, activities that can be done without help, with some help or which ^YOU2 ^ARE unable to do. You may feel that some of these questions do not apply to ^YOU2, but it is important that we ask the same questions of everyone.
INTERVIEWER : Press <Enter> to continue.

IAL_D01A

(not applicable)

IAL_Q01A

Can ^YOU2 use the telephone without help, including looking up numbers and dialling?
1 Yes (Go to IAL_Q02A)
2 No
DK , RF (Go to IAL_END)

IAL_Q01B

Can ^YOU1 use the telephone with some help (^YOU1 can answer the phone or dial the operator in an emergency, but need^S a special phone or help in getting the number or dialling)?
1 Yes (Go to IAL_Q02A)
2 No
DK , RF (Go to IAL_Q02A)

IAL_Q01C

^ARE_C ^YOU1 completely unable to use the telephone?
1 Yes
2 No
DK , RF

IAL_E01C

You cannot select "No" if the answer to the previous question is also "No."

Note:

Trigger hard edit IAL_Q01C = 2 and IAL_Q01B = 2.

IAL_Q02A

Can ^YOU2 get to places out of walking distance without help (^YOU1 drive^S ^YOUR1 own car, or travel^S alone on buses, or taxis)?
INTERVIEWER : If respondent uses Para–transport, code as a "Yes."
1 Yes (Go to IAL_Q03A)
2 No
DK , RF (Go to IAL_Q03A)

IAL_Q02B

Can ^YOU1 get to places out of walking distance with some help (^YOU1 need^S someone to help ^HIMHER or go with ^HIMHER when travelling)?
1 Yes (Go to IAL_Q03A)
2 No
DK , RF (Go to IAL_Q03A)

IAL_Q02C

^ARE_C ^YOU1 unable to travel unless emergency arrangements are made for a specialized vehicle, like an ambulance?
1 Yes
2 No
DK , RF

IAL_E02C

You cannot select "No" if the answer to the previous question is also "No."

Note:

Trigger hard edit if IAL_Q02C = 2 and IAL_Q02B = 2.

IAL_Q03A

Can ^YOU2 go shopping for groceries or clothes without help (taking care of all shopping needs ^YOURSELF)?
INTERVIEWER : Assuming the respondent has transportation.
1 Yes (Go to IAL_Q04A)
2 No
DK , RF (Go to IAL_Q04A)

IAL_Q03B

Can ^YOU1 go shopping for groceries or clothes with some help (^YOU1 need^S someone to go with ^HIMHER on all shopping trips)?
INTERVIEWER : Assuming the respondent has transportation.
1 Yes (Go to IAL_Q04A)
2 No
DK , RF (Go to IAL_Q04A)

IAL_Q03C

^ARE_C ^YOU1 completely unable to do any shopping?
1 Yes
2 No
DK , RF

IAL_E03C

You cannot select "No" if the answer to the previous question is also "No."

Note:

Trigger hard edit if IAL_Q03C = 2 and IAL_Q03B = 2.

IAL_Q04A

Can ^YOU2 prepare ^YOUR1 own meals without help (^YOU1 plan^S and cook^S full meals ^YOURSELF)?
INTERVIEWER : If respondent is capable of doing this task with no help, code as a "Yes"
1 Yes (Go to IAL_Q05A)
2 No
DK , RF (Go to IAL_Q05A)

IAL_Q04B

Can ^YOU1 prepare ^YOUR1 own meals with some help (^YOU1 can prepare some things but ^ARE unable to cook full meals ^YOURSELF)?
INTERVIEWER : If respondent is capable of doing this task with some help, code as a "Yes".
1 Yes (Go to IAL_Q05A)
2 No
DK , RF (Go to IAL_Q05A)

IAL_Q04C

^ARE_C ^YOU1 completely unable to prepare any meals?
1 Yes
2 No
DK , RF

IAL_E04C

You cannot select "No" if the answer to the previous question is also "No."

Note:

Trigger hard edit si IAL_Q04C = 2 et IAL_Q04B = 2.

IAL_Q05A

Can ^YOU2 do ^YOUR1 housework without help (^YOU1 can clean floors, etc.)?
1 Yes (Go to IAL_Q06A)
2 No
DK , RF (Go to IAL_Q06A)

IAL_Q05B

Can ^YOU1 do ^YOUR1 housework with some help (^YOU1 can do light housework but need^S help with heavy work)?
1 Yes (Go to IAL_Q06A)
2 No
DK , RF (Go to IAL_Q06A)

IAL_Q05C

^ARE_C ^YOU1 completely unable to do any housework?
1 Yes
2 No
DK , RF

IAL_E05C

You cannot select "No" if the answer to the previous question is also "No."

Note:

Trigger hard edit if IAL_Q05C = 2 et IAL_Q05B = 2.

IAL_Q06A

Can ^YOU2 take ^YOUR1 own medicine without help (in the right doses at the right time)?
INTERVIEWER : If respondent occasionally forgets, code as a "Yes".
1 Yes (Go to IAL_Q07A)
2 No
DK , RF (Go to IAL_Q07A)

IAL_Q06B

Can ^YOU1 take ^YOUR1 own medicine with some help (^YOU1 ^ARE able to take medicine if someone prepares it for ^HIMHER or reminds ^HIMHER to take it)?
1 Yes (Go to IAL_Q07A)
2 No
DK , RF (Go to IAL_Q07A)

IAL_Q06C

^ARE_C ^YOU1 completely unable to take ^YOUR1 medicine?
1 Yes
2 No
DK , RF

IAL_E06C

You cannot select "No" if the answer to the previous question is also "No."

Note:

Trigger hard edit if IAL_Q06C = 2 et IAL_Q06B = 2.

IAL_Q07A

Can ^YOU2 handle ^YOUR1 own money without help (^YOU1 write^S cheques, pay bills, etc.)?
INTERVIEWER : If respondent occasionally forgets, code as a "Yes".
1 Yes (Go to IAL_END)
2 No
DK , RF (Go to IAL_END)

IAL_Q07B

Can ^YOU1 handle ^YOUR1 own money with some help (^YOU1 manage^S day–to–day buying but need^S help with managing ^YOUR1 chequebook or paying ^YOUR1 bills)?
1 Yes (Go to IAL_END)
2 No
DK , RF (Go to IAL_END)

IAL_Q07C

^ARE_C ^YOU1 completely unable to handle ^YOUR1 money?
1 Yes
2 No
DK , RF

IAL_E07C

You cannot select "No" if the answer to the previous question is also "No."

Note:

Trigger hard edit if IAL_Q07C = 2 and IAL_Q07B = 2.

IAL_END

Basic activities of daily living (ADL)

ADL_BEG

This module is a modification of the activities of daily living questions of the OARS Multidimensional Assessment Questionnaire© developed by Dr. Gerda G. Fillenbaum (Duke University Medical Center). The author granted permission to Statistics Canada for the use of the activities of daily living questions in this survey.
External variables required:
PROXMODE: proxy identifier from the GR block
FNAME: first name of respondent
DOIAL : do block flag from the sample file
PE_Q01 : first name of specific respondent from USU block
PE_Q02 : last name of specific respondent from USU block
Screen display:
Display on header bar PE_Q01 and PE_Q02 separated by a space

ADL_C01

If DOADL=1, go to ADL_R01A.
Otherwise, go to ADL_END.

ADL_R01A

Now I’d like to ask you about some other basic activities of daily living. Remember, these are activities that can be done without help, with some help or which ^YOU2 ^ARE unable to do.
INTERVIEWER : Press <Enter> to continue.

ADL_Q01A

Can ^YOU2 eat without help (^YOU1 ^ARE able to feed ^YOURSELF completely)?
1 Yes (Go to ADL_Q02A)
2 No
DK , RF (Go to ADL_END)

ADL_Q01B

Can ^YOU1 eat with some help (^YOU1 need^S help with cutting ^YOUR1 food, etc.)?
1 Yes (Go to ADL_Q02A)
2 No
DK , RF (Go to ADL_Q02A)

ADL_Q01C

^ARE_C ^YOU1 completely unable to feed ^YOURSELF?
1 Yes
2 No
DK , RF

ADL_E01C

You cannot select "No" if the answer to the previous question is also "No."

Note:

Trigger hard edit if ADL_Q01C = 2 and ADL_Q01B = 2.

ADL_Q02A

Can ^YOU2 dress and undress ^YOURSELF without help (including picking out clothes)?
1 Yes (Go to ADL_Q03A)
2 No
DK , RF (Go to ADL_Q03A)

ADL_Q02B

Can ^YOU1 dress and undress ^YOURSELF with some help?
1 Yes (Go to ADL_Q03A)
2 No
DK , RF (Go to ADL_Q03A)

ADL_Q02C

^ARE_C ^YOU1 completely unable to dress and undress ^YOURSELF?
1 Yes
2 No
DK , RF

ADL_E02C

You cannot select "No" if the answer to the previous question is also "No."

Note:

Trigger hard edit if ADL_Q02C = 2 and ADL_Q02B = 2.

ADL_D03A

If SEX_Q01 = 1 (male), ^DT_SHAVING = "and shaving".
Otherwise, ^DT_SHAVING = "(null)".

ADL_Q03A

Can ^YOU2 take care of ^YOUR1 own appearance without help, for example, combing ^YOUR1 hair ^DT_SHAVING?
1 Yes (Go to ADL_Q04A)
2 No
DK , RF (Go to ADL_Q04A)

ADL_Q03B

Can ^YOU1 take care of ^YOUR1 own appearance with some help?
1 Yes (Go to ADL_Q04A)
2 No
DK , RF (Go to ADL_Q04A)

ADL_Q03C

^ARE_C ^YOU1 completely unable to take care of ^YOUR1 own appearance?
1 Yes
2 No
DK , RF

ADL_E03C

You cannot select "No" if the answer to the previous question is also "No."

Note:

Trigger hard edit if ADL_Q03C = 2 and ADL_Q03B = 2.

ADL_Q04A

Can ^YOU2 walk without help?
INTERVIEWER : If respondent walks with a cane, code as "Yes".
1 Yes (Go to ADL_Q05A)
2 No
DK , RF (Go to ADL_Q05A)

ADL_Q04B

Can ^YOU1 walk with some help from a person, or with the use of a walker or crutches, etc.?
1 Yes (Go to ADL_Q05A)
2 No
DK , RF (Go to ADL_Q05A)

ADL_Q04C

^ARE_C ^YOU1 completely unable to walk?
1 Yes
2 No
DK , RF

ADL_E04C

You cannot select "No" if the answer to the previous question is also "No."

Note:

Trigger hard edit if ADL_Q04C = 2 and ADL_Q04B = 2.

ADL_Q05A

Can ^YOU1 get in and out of bed without any help or aids?
1 Yes (Go to ADL_Q06A)
2 No
DK , RF (Go to ADL_Q06A)

ADL_Q05B

Can ^YOU1 get in and out of bed with some help (either from a person or with the aid of some device)?
1 Yes (Go to ADL_Q06A)
2 No
DK , RF (Go to ADL_Q06A)

ADL_Q05C

^ARE_C ^YOU1 totally dependent on someone else to lift ^HIMHER in and out of bed?
1 Yes
2 No
DK , RF

ADL_E05C

You cannot select "No" if the answer to the previous question is also "No."

Note:

Trigger hard edit if ADL_Q05C = 2 and ADL_Q05B = 2.

ADL_Q06A

Can ^YOU1 take a bath or shower without help?
1 Yes (Go to ADL_Q07A)
2 No
DK , RF (Go to ADL_Q07A)

ADL_Q06B

Can ^YOU1 take a bath or shower with some help (^YOU1 need^S help from someone getting in and out of the tub or ^YOU1 need^S special attachments on the tub)?
1 Yes (Go to ADL_Q07A)
2 No
DK , RF (Go to ADL_Q07A)

ADL_Q06C

^ARE_C ^YOU1 completely unable to take a bath and a shower ^YOURSELF?
1 Yes
2 No
DK , RF

ADL_E06C

You cannot select "No" if the answer to the previous question is also "No."

Note:

Trigger hard edit if ADL_Q06C = 2 and ADL_Q06B = 2.

ADL_Q07A

^DOVERB_C ^YOU1 ever have trouble getting to the bathroom on time?
1 Yes
2 No (Go to ADL_END)
3 No, has a catheter or colostomy (Go to ADL_END)
DK , RF (Go to ADL_END)

ADL_Q07B

How often ^DOVERB ^YOU1 wet or soil ^YOURSELF (either day or night)?
1 Never or less than once a week
2 Once or twice a week
3 Three times a week or more
DK , RF

ADL_END

Health care utilization 2 (HC2)

HC2_BEG

Content block
External variables required:
PROXMODE: proxy identifier, from the GR block
FNAME: first name of selected respondent
DOHC2: do block flag from sample file
PE_Q01: first name of specific respondent from USU block
PE_Q02: last name of specific respondent from USU block
REFDATE: current date from operating system
SELRESPGENDER: sex of selected respondent
Screen display:
Display on header bar PE_Q01 and PE_Q02 separated by a space

HC2_C01

If DOHC2 = 1, go to HC2_R01.
Otherwise, go to HC2_ END.

HC2_D01A

YEARAGO = REFDATE – one year.

Note:

Display YEARAGO as Month DD, YYYY, e.g. January 2, 2008.

HC2_D01B

(not applicable)

HC2_R01

Now I’d like to ask about ^YOUR2 contacts with various health professionals during the past 12 months, that is, from ^YEARAGO to yesterday.
INTERVIEWER : Press <Enter> to continue.

HC2_Q01

^DOVERB_C ^YOU1 have a regular medical doctor?
1 Yes (Go to HC2_Q04)
2 No
DK , RF (Go to HC2_Q04)

HC2_D02

If PROXMODE= 1, GOVERB = "goes".
Otherwise, GOVERB = "go".

HC2_Q02

Is there a place that ^YOU1 usually ^GOVERB to when ^YOU1 ^ARE sick or need^S advice about ^YOUR1 health?
1 Yes
2 No (Go to HC2_Q04)
DK , RF (Go to HC2_Q04)

HC2_Q03

What kind of place is it?
INTERVIEWER : If the respondent indicates more than one usual place, then ask: What kind of place ^DOVERB ^YOU1 go to most often?
1 Doctor’s office
2 Community health centre / CLSC
3 Walk–in clinic
4 Appointment clinic
5 Telephone health line (for example, HealthLinks, Telehealth Ontario,
Health–Line, TeleCare, Info–Santé)
6 Hospital emergency room
7 Hospital outpatient clinic
8 Other – Specify (Go to HC2_S03)
DK , RF
Go to HC2_Q04

HC2_S03

INTERVIEWER : Specify.
(80 spaces)
DK , RF

HC2_Q04

In the past 12 months, ^HAVE ^YOU1 been a patient overnight in a hospital, nursing home or convalescent home?
1 Yes
2 No (Go to HC2_Q06)
DK , RF (Go to HC2_Q06)

HC2_Q05

For how many nights in the past 12 months?
Nights
( MIN : 1) ( MAX : 366; warning after 100)
DK , RF

HC2_E05

An unusual value has been entered. Please confirm.

Note:

Trigger soft edit if HC2_Q05 > 100.

HC2_D06A

If HC2_Q04 = 1, DT_NOTCOUNT = "Not counting when ^YOU1 ^WERE an overnight patient, in the past 12 months".
Otherwise, DT_NOTCOUNT = "In the past 12 months".

HC2_D06B

If SELFRESPGENDER = 1, DT_SPECIALIST = "urologist".
Otherwise, DT_SPECIALIST = "gynaecologist".

HC2_Q06

(Please refer to page 3 of the booklet.) ^DT_NOTCOUNT, ^HAVE ^YOU1 seen, or talked to any of the following health professionals about ^YOUR1 physical, emotional or mental health?
INTERVIEWER : Read categories to respondent. Mark all that apply.
01 A family doctor or general practitioner
02 An eye specialist, such as an ophthalmologist or optometrist
03 Any other medical doctor or specialist such as a surgeon, allergist, orthopaedist, ^DT_SPECIALIST or psychiatrist
04 A nurse for care or advice
05 A dentist, dental hygienist or orthodontist
06 A chiropractor
07 A physiotherapist
08 A psychologist
09 A social worker or counsellor
10 An audiologist, speech or occupational therapist
11 Other – Specify (Go to HC2_S06)
12 Did not see any health professional
DK , RF
Go to HC2_Q07

HC2_E06

You cannot select "Did not see any health professional" and another category. Please return and correct.

Note:

Trigger hard edit if HC2_Q06 = 12 and at least one other response.

HC2_S0

INTERVIEWER : Specify.
(80 spaces)
DK , RF

HC2_Q07

People may also use alternative or complementary medicine. In the past 12 months, ^HAVE ^YOU1 seen or talked to an alternative health care provider such as an acupuncturist, homeopath or massage therapist about ^YOUR1 physical, emotional or mental health?
INTERVIEWER : Other alternative health care providers: naturopath, Feldenkrais or Alexander teacher, relaxation therapist, biofeedback teacher, rolfer, herbalist, reflexologist, spiritual healer, religious healer.
1 Yes
2 No
DK , RF

HC2_END

Care receiving 1 (CR1)

CR1_BEG

Content block
External variables required:
PROXMODE: proxy identifier from the GR block
FNAME: first name of respondent from household block
DOCR1: do block flag from the sample file
PE_Q01 : first name of specific respondent from USU block
PE_Q02 : last name of specific respondent from USU block
Screen display:
Display on header bar PE_Q01 and PE_Q02 separated by a space

CR1_C01

If DOCR1 = 1, go to CR1_R01.
Otherwise, go to CR1_END.

CR1_R01

(Please refer to page 4 of the booklet.) Now some questions on home care services ^YOU2 may have received because of a health condition or limitation that affects ^YOUR2 daily activities. These services include health care, homemaker or other support services received at home. Please include only services provided by professionals. Exclude assistance from family, friends, or neighbours.
INTERVIEWER : Press <Enter> to continue.

CR1_Q01

During the past 12 months, did ^YOU2 receive short–term or long–term professional assistance at home, because of a health condition or limitation that affects ^YOUR1 daily life, for any of the following activities?
INTERVIEWER : Read categories to respondent. Mark all that apply. By professional assistance, we mean help from paid workers or volunteer organizations. Include assistance received because of physical, mental or cognitive health problems or limitations or because of aging.
1 Personal care such as assistance with eating, dressing, bathing, or toileting
2 Medical care such as help taking medicine or help with nursing care (for example, dressing changes or foot care)
3 Managing care such as making appointments
4 Help with activities such as housework, home maintenance or outdoor work
5 Transportation, including trips to the doctor or for shopping
6 Meal preparation or delivery
7 None (Go to CR1_Q03)
8 Other – Specify (Go to CR1_S01)
DK , RF (Go to CR1_END)
Go to CR1_C02

CR1_S0

1 INTERVIEWER : Specify.
(80 spaces)
DK , RF

CR1_E01

You cannot select "None" and another category. Please return and correct.

Note:

Trigger hard edit if CR1_Q01 = 7 and any other response.

CR1_C02

If more than one source of assistance is indicated in CR1_Q01, go to CR1_Q02.
Otherwise, go to CR1_Q03.

CR1_Q02

For which type of activity did ^YOU1 receive the most assistance?
INTERVIEWER : "Most assistance" can be measured in time or effort; whichever the respondent decides.
1 Personal care such as assistance with eating, dressing, bathing, or toileting
2 Medical care such as help taking medicine or help with nursing care (for example, dressing changes or foot care)
3 Managing care such as making appointments
4 Help with activities such as housework, home maintenance or outdoor work
5 Transportation, including trips to the doctor or for shopping
6 Meal preparation or delivery
7 ^CR1_S01
DK , RF
Go to CR1_Q03

Note:

At the time of the data processing, if the respondent reported only one source of care in CR1_Q01, the variable CR1_Q02 will be given its value.

CR1_E02

You cannot select a type of assistance that was not selected in CR1_Q01. Please return

Note:

Trigger hard edit if the selected category in CR1_Q02 was not selected in CR1_Q01.

CR1_Q03

During the past 12 months, was there ever a time when ^YOU2 felt that ^YOU1 needed professional home care services but ^YOU1 didn’t receive them?
INTERVIEWER : Exclude assistance from family, friends or neighbours. By "professional home care services" we mean health care, home maker or other support services received at home from paid workers or volunteer organizations due to a health condition or limitation.
1 Yes
2 No (Go to CR1_END)
DK , RF (Go to CR1_END)

CR1_Q04

Thinking of the most recent time, why didn’t ^YOU1 get these services?
INTERVIEWER : Mark all that apply.
01 Not available – in the area
02 Not available – at time required (e.g., inconvenient hours)
03 Waiting time too long
04 Felt would be inadequate
05 Cost
06 Too busy
07 Didn’t get around to it / didn’t bother
08 Didn’t know where to go / call
09 Language problems
10 Personal or family responsibilities
11 Decided not to seek services
12 Doctor – did not think it was necessary
13 Did not qualify / not eligible for home care
14 Still waiting for home care
15 Other – Specify (Go to CR1_S04)
DK , RF
Go to CR1_Q05

CR1_S04

INTERVIEWER : Specify.
(80 spaces)
DK , RF

CR1_Q05

(Please refer to page 4 of the booklet.) Again, thinking of the most recent time, what type of home care was needed?
INTERVIEWER : Mark all that apply.
1 Personal care such as assistance with eating, dressing, bathing, or toileting
2 Medical care such as help taking medicine or help with nursing care (for example, dressing changes or foot care)
3 Managing care such as making appointments
4 Help with activities such as housework, home maintenance or outdoor work
5 Transportation, including trips to the doctor or for shopping
6 Meal preparation or delivery
7 Other – Specify (Go to CR1_S05)
DK , RF
Go to CR1_END

CR1_S05

INTERVIEWER : Specify.
(80 spaces)
DK , RF

CR1_END

Care receiving 2 (CR2)

CR2_BEG

Content block
External variables required:
PROXMODE: proxy identifier from the GR block
FNAME: first name of respondent from the household block
DOCR2 : do block flag from the sample file
PERSONID : identifier of specific respondent in household
PE_Q01 : first name of specific respondent from USU block
PE_Q02 : last name of specific respondent from USU block
ANDB_Q01: Age of specific respondent from ANDB block
PID : Person IDs of all current household members except specific respondent
FirstName : first names of all current household members except specific respondent
LastName : last names of all current household members except specific respondent

CR2_C01A

Screen display:
If DOCR2 = 1, go to CR2_R01A.
Otherwise, go to CR2_END.

CR2_R01A

(Please refer to page 4 of the booklet.) The following questions are about different types of assistance that ^YOU2 may have received because of a health condition or limitation that affects ^YOUR2 daily activities. Please include only assistance from family, friends, or neighbours. Exclude assistance from paid workers or volunteer organizations.
INTERVIEWER : Press <Enter> to continue.

CR2_Q01A

During the past 12 months, did ^YOU2 receive short–term or long–term assistance, because of a health condition or limitation that affects ^YOUR1 daily life, for any of the following activities from family, friends, or neighbours?
INTERVIEWER : Read categories to respondent. Mark all that apply. Include assistance received because of physical, mental or cognitive health problems or limitations or because of aging.
1 Personal care such as assistance with eating, dressing, bathing, or toileting
2 Medical care such as help taking medicine or help with nursing care (for example, dressing changes or foot care)
3 Managing care such as making appointments
4 Help with activities such as housework, home maintenance or outdoor work
5 Transportation, including trips to the doctor or for shopping
6 Meal preparation or delivery
7 None (Go to CR2_END)
8 Other – Specify (Go to CR2_S01A)
DK , RF (Go to CR2_END)
Go to CR2_C01B

CR2_S01A

INTERVIEWER : Specify.
(80 spaces)
DK , RF

CR2_E01A

You cannot select "None" and another category. Please return and correct.

Note:

Trigger hard edit if CR2_Q01A = 7 and any other response.

CR2_C01B

If more than one source of care is indicated in CR2_Q01A, go to CR2_ Q01B.
Otherwise, go to CR2_D02.

CR2_Q01B

For which type of activity did ^YOU2 receive the most assistance?
INTERVIEWER : "Most assistance" can be measured in time or effort; whichever the respondent decides.
1 Personal care such as assistance with eating, dressing, bathing, or toileting
2 Medical care such as help taking medicine or help with nursing care (for example, dressing changes or foot care)
3 Managing care such as making appointments
4 Help with activities such as housework, home maintenance or outdoor work
5 Transportation, including trips to the doctor or for shopping
6 Meal preparation or delivery
7 ^CR2_S01A
DK , RF (Go to CR2_END)
Go to CR2_D03

Note:

At the time of the data processing, if the respondent reported only one source of assistance in CR2_Q01A, the variable CR2_Q01B will be given its value.

CR2_E01B

You cannot select a type of assistance that was not selected in CR2_Q01A. Please return and correct.

Note:

Trigger hard edit if the response in CR2_Q01B was not selected in CR2_Q01A.

CR2_D02

CR2_Q01B = CR2_Q01A

CR2_D03

If CR2_Q01B = 1, KEY_PHRASE2 = "personal care".
If CR2_Q01B = 2, KEY_PHRASE2 = "medical care".
If CR2_Q01B = 3, KEY_PHRASE2 = "managing care".
If CR2_Q01B = 4, KEY_PHRASE2 = "housework or home maintenance".
If CR2_Q01B = 5, KEY_PHRASE2 = "transportation".
If CR2_Q01B = 6, KEY_PHRASE2 = "meal preparation or delivery".
If CR2_Q01B = 7, KEY_PHRASE2 = "the other care you specified".

CR2_R04

You mentioned that during the past 12 months, ^YOU2 received assistance with ^KEY_PHRASE2. We are interested in finding out a little bit more about the person who has dedicated the most time and resources to helping ^YOU2 with this activity.
INTERVIEWER : Press <Enter> to continue.

CR2_Q04

Is the person from whom ^YOU2 received the most assistance:
INTERVIEWER : Read categories to respondent. Only select 1 if care giver is currently living in the household.
1 …living in this household? (Go to CR2_Q07)
2 …living outside of this household? (Go to CR2_Q12)
DK (Go to CR2_Q12)
RF (Go to CR2_END)

CR2_Q07

What is the name of this person?
INTERVIEWER : Select the care giver.

Note:

Screen display: Display all current household members ( PID and FirstName and LastName).

CR2_E07A

An impossible value has been entered. Please return and correct.

Note:

Trigger hard edit if answer in CR2_Q07 is not displayed.

CR2_E07B

Selected household member must be over the age of 10. Please return and correct.

Note:

Trigger hard edit if ANDB_Q01 < 10.

CR2_D08

If CR2_Q07 = response, ASST_NAME2 = FirstName.
Otherwise, ASST_NAME2 = "null"
Go to CR2_Q16

Note:

At the time of data processing, if the respondent reported that the care giver lived in the same household as the respondent, then the data on sex, age, and relationship of that person will be copied from the household roster into CR2_Q12, CR2_Q14, and CR2_Q15, respectively.

CR2_Q12

Is the person who provided the most assistance:
INTERVIEWER : Read categories to respondent.
1 …a male?
2 …a female?
DK , RF (Go to CR2_END)

CR2_Q13

What is the first name of this person?
(25 spaces)
DK , RF (Go to CR2_END)

CR2_D13

ASST_NAME2 = CR2_Q13

CR2_Q14

How old is ^ASST_NAME2?
years
( MIN : 10) ( MAX : 130)
DK , RF

CR2_Q15

What is the relationship between ^YOU2 and ^ASST_NAME2? Is ^ASST_NAME2 ^YOUR1:
INTERVIEWER : Read categories to respondent.
01 …husband (or wife)?
02 …common–law partner?
03 …parent?
04 …child?
05 …sibling?
06 …grandchild?
07 …father–in–law (or mother–in–law)?
08 …son–in–law (or daughter–in–law)?
09 …brother–in–law (or sister–in–law)?
10 …other relative?
11 …friend, neighbour, or other?
DK , RF

CR2_Q16

How long ^HAVE ^YOU2 been receiving assistance from ^ASST_NAME2 for ^KEY_PHRASE2?
INTERVIEWER : Read categories to respondent.
1 Less than six months
2 Six months to less than one year
3 One year to less than three years
4 Three years to less than five years
5 Five years or more
DK , RF

CR2_Q17A

During the past 12 months, did ^YOU1 receive assistance from ^ASST_NAME2 with ^KEY_PHRASE2:
INTERVIEWER : Read categories to respondent.
1 …on a regular basis?
2 …occasionally or infrequently? (Go to CR2_END)
DK , RF

CR2_Q17B

(During the past 12 months,) how often did ^YOU2 receive assistance from ^ASST_NAME2 with ^KEY_PHRASE2? Was it:
INTERVIEWER : Read categories to respondent.
1 …daily?
2 …at least once a week?
3 …at least once a month?
4 …less than once a month?
DK , RF (Go to CR2_END)

CR2_D18

If CR2_Q17B = 1, DT_OFTEN1 = "day".
If CR2_Q17B = 2, DT_OFTEN1 = "week".
If CR2_Q17B = 3, DT_OFTEN1 = "month".
If CR2_Q17B = 4, DT_OFTEN1 = "occasion".
Otherwise, DT_OFTEN1 = "null".

CR2_Q18

(During the past 12 months,) how much time in an average ^DT_OFTEN1 did ^ASST_NAME2 spend assisting ^YOU2 with ^KEY_PHRASE2? Was it:
INTERVIEWER : Read categories to respondent.
1 …less than 1 hour?
2 …1 hour to less than 3 hours?
3 …3 hours to less than 5 hours?
4 …5 hours to less than 10 hours?
5 …10 hours or more?
DK , RF

CR2_END

Social support – availability (SSA)

SSA_BEG

Content block
External variables required:
PROXMODE: proxy identifier, from the GR block
FNAME: first name of respondent from household block
DOSSA: do block flag, from the sample file
PE_Q01 : first name of specific respondent from USU block
PE_Q02 : last name of specific respondent from USU block
Screen display:
Display on header bar PE_Q01 and PE_Q02 separated by a space

SSA_C1

If DOSSA = 1, go to SSA_C2.
Otherwise, go to SSA_END.

SSA_C2

If PROXMODE = 1, go to SSA_END.
Otherwise, go to SSA_R1.

SSA_R1

Next are some questions about the support that is available to you.
INTERVIEWER : Press <Enter> to continue.

SSA_Q01

Starting with a question on friendship, about how many close friends and close relatives do you have, that is, people you feel at ease with and can talk to about what is on your mind?
Close friends
( MIN : 0) ( MAX : 99; warning after 20)
DK , RF (Go to SSA_END)

SSA_R2

(Please refer to page 5 of the booklet.)
People sometimes look to others for companionship, assistance or other types of support.
INTERVIEWER : Press <Enter> to continue.

SSA_Q02

How often is each of the following kinds of support available to you if you need it:
…someone to help you if you were confined to bed?
INTERVIEWER : Read categories to respondent.
1 None of the time
2 A little of the time
3 Some of the time
4 Most of the time
5 All of the time
DK , RF (Go to SSA_END)

SSA_Q03

(How often is each of the following kinds of support available to you if you need it:)
…someone you can count on to listen to you when you need to talk?
1 None of the time
2 A little of the time
3 Some of the time
4 Most of the time
5 All of the time
DK , RF

SSA_Q04

(How often is each of the following kinds of support available to you if you need it:)
…someone to give you advice about a crisis?
1 None of the time
2 A little of the time
3 Some of the time
4 Most of the time
5 All of the time
DK , RF

SSA_Q05

(How often is each of the following kinds of support available to you if you need it:)
…someone to take you to the doctor if you needed it?
1 None of the time
2 A little of the time
3 Some of the time
4 Most of the time
5 All of the time
DK , RF

SSA_Q06

(How often is each of the following kinds of support available to you if you need it:)
…someone who shows you love and affection?
1 None of the time
2 A little of the time
3 Some of the time
4 Most of the time
5 All of the time
DK , RF

SSA_Q07

Again, how often is each of the following kinds of support available to you if you need it:
…someone to have a good time with?
1 None of the time
2 A little of the time
3 Some of the time
4 Most of the time
5 All of the time
DK , RF

SSA_Q08

(How often is each of the following kinds of support available to you if you need it:)
…someone to give you information in order to help you understand a situation?
1 None of the time
2 A little of the time
3 Some of the time
4 Most of the time
5 All of the time
DK , RF

SSA_Q09

(How often is each of the following kinds of support available to you if you need it:)
…someone to confide in or talk to about yourself or your problems?
1 None of the time
2 A little of the time
3 Some of the time
4 Most of the time
5 All of the time
DK , RF

SSA_Q10

(How often is each of the following kinds of support available to you if you need it:)
…someone who hugs you?
1 None of the time
2 A little of the time
3 Some of the time
4 Most of the time
5 All of the time
DK , RF

SSA_Q11

(How often is each of the following kinds of support available to you if you need it:)
…someone to get together with for relaxation?
1 None of the time
2 A little of the time
3 Some of the time
4 Most of the time
5 All of the time
DK , RF

SSA_Q12

(How often is each of the following kinds of support available to you if you need it:)
…someone to prepare your meals if you were unable to do it yourself?
1 None of the time
2 A little of the time
3 Some of the time
4 Most of the time
5 All of the time
DK , RF

SSA_Q13

(How often is each of the following kinds of support available to you if you need it:)
…someone whose advice you really want?
1 None of the time
2 A little of the time
3 Some of the time
4 Most of the time
5 All of the time
DK , RF

SSA_Q14

Again, how often is each of the following kinds of support available to you if you need it:
…someone to do things with to help you get your mind off things?
1 None of the time
2 A little of the time
3 Some of the time
4 Most of the time
5 All of the time
DK , RF

SSA_Q15

(How often is each of the following kinds of support available to you if you need it:)
…someone to help with daily chores if you were sick?
1 None of the time
2 A little of the time
3 Some of the time
4 Most of the time
5 All of the time
DK , RF

SSA_Q16

(How often is each of the following kinds of support available to you if you need it:)
…someone to share your most private worries and fears with?
1 None of the time
2 A little of the time
3 Some of the time
4 Most of the time
5 All of the time
DK , RF

SSA_Q17

(How often is each of the following kinds of support available to you if you need it:)
…someone to turn to for suggestions about how to deal with a personal problem?
1 None of the time
2 A little of the time
3 Some of the time
4 Most of the time
5 All of the time
DK , RF

SSA_Q18

(How often is each of the following kinds of support available to you if you need it:)
…someone to do something enjoyable with?
1 None of the time
2 A little of the time
3 Some of the time
4 Most of the time
5 All of the time
DK , RF

SSA_Q19

(How often is each of the following kinds of support available to you if you need it:)
…someone who understands your problems?
1 None of the time
2 A little of the time
3 Some of the time
4 Most of the time
5 All of the time
DK , RF

SSA_Q20

(How often is each of the following kinds of support available to you if you need it:)
…someone to love you and make you feel wanted?
1 None of the time
2 A little of the time
3 Some of the time
4 Most of the time
5 All of the time
DK , RF

SSA_Q21

^DOVERB_C ^YOU2 have a household pet that provides ^HIMHER with companionship?
1 Yes
2 No
DK , RF

SSA_END

Social participation (SPA)

SPA_BEG

Content block
External variables required:
PROXMODE: proxy identifier from the GR block
FNAME: first name of selected respondent
DOSPA: do block flag from the sample file
PE_Q01: first name of specific respondent from USU block
PE_Q02: last name of specific respondent from USU block
Screen display:
Display on header bar PE_Q01 and PE_Q02 separated by a space

SPA_C01

If DOSPA = 1, go to SPA_R01.
Otherwise, go to SPA_END.

SPA_R01

(Please refer to page 6 of the booklet.)
The next questions are about community–related activities that ^YOU2 may have participated in during the past 12 months.
INTERVIEWER : Press <Enter> to continue.

SPA_Q01

In the past 12 months, how often did ^YOU2 participate in:
…family or friendship activities outside the household?
INTERVIEWER : Read categories to respondent.
Examples include informal and formal activities such as small get–togethers, meals outside the household, weddings or reunions.
1 At least once a day
2 At least once a week
3 At least once a month
4 At least once a year
5 Never
DK , RF (Go to SPA_END)

SPA_Q02

In the past 12 months, how often did ^YOU1 participate in:
…church or religious activities such as services, committees or choirs?
INTERVIEWER : Read categories to respondent.
1 At least once a day
2 At least once a week
3 At least once a month
4 At least once a year
5 Never
DK , RF

SPA_Q03

(In the past 12 months, how often did ^YOU1 participate in:)
…sports or physical activities that ^YOU1 ^DOVERB with other people?
1 At least once a day
2 At least once a week
3 At least once a month
4 At least once a year
5 Never
DK , RF

SPA_Q04

(In the past 12 months, how often did ^YOU1 participate in:)
…educational and cultural activities involving other people such as attending courses, concerts or visiting museums?
1 At least once a day
2 At least once a week
3 At least once a month
4 At least once a year
5 Never
DK , RF

SPA_Q05

(In the past 12 months, how often did ^YOU1 participate in:)
…service club or fraternal organization activities?
INTERVIEWER : Examples include Lion’s Club, Knights of Columbus, Kiwanis Club, Royal Canadian Legion, Daughters of Isabella and Seniors Club.
1 At least once a day
2 At least once a week
3 At least once a month
4 At least once a year
5 Never
DK , RF

SPA_Q06

(In the past 12 months, how often did ^YOU1 participate in:)
…neighbourhood, community or professional association activities?
1 At least once a day
2 At least once a week
3 At least once a month
4 At least once a year
5 Never
DK , RF

SPA_Q07

(In the past 12 months, how often did ^YOU1 participate in:)
…volunteer or charity work?
1 At least once a day
2 At least once a week
3 At least once a month
4 At least once a year
5 Never
DK , RF

SPA_Q08

(In the past 12 months, how often did ^YOU1 participate in:)
…any other recreational activities involving other people, including hobbies, bingo and other games?
1 At least once a day
2 At least once a week
3 At least once a month
4 At least once a year
5 Never
DK , RF

SPA_C09

If PROXMODE = 1, go to SPA_END.
Otherwise, go to SPA_Q09.

SPA_Q09

In the past 12 months, have you felt like you wanted to participate in more social, recreational or group activities?
1 Yes
2 No (Go to SPA_END)
DK , RF (Go to SPA_END)

SPA_D10A

If SPA_Q01 = 5 and SPA_Q02 = 5 and SPA_Q03 = 5 and SPA_Q04 = 5 and SPA_Q05 = 5 and SPA_Q06 = 5 and SPA_Q07 = 5 and SPA_Q08 = 5, ACTIVITIES_E = "activities".
Otherwise, ACTIVITIES_E = "more activities".

SPA_Q10

What prevented you from participating in ^ACTIVITIES_E?
INTERVIEWER : Mark all that apply.
01 Cost
02 Transportation problems
03 Activities not available in the area
04 Location not physically accessible
05 Location is too far
06 Health condition limitation
07 Time of the activities not suitable
08 Don’t want to go alone
09 Personal or family responsibilities
10 Language related reasons
11 Too busy
12 Afraid or concerns about safety
13 Other – Specify (Go to SPA_S10)
DK , RF
Go to SPA_END

SPA_S10

INTERVIEWER : Specify.
(80 spaces)
DK , RF

SPA_END

Care giving (CAG)

CAG_BEG

Content block
External variables required:
PROXMODE: proxy identifier from the GR block
FNAME: first name of respondent from household block
DOCAG: do block flag from the sample file
DOCGE: do block flag from the sample file
PERSONID: identifier of specific respondent in household
PE_Q01: first name of specific respondent from USU block
PE_Q02: last name of specific respondent from USU block
Screen display:
Display on header bar PE_Q01 and PE_Q02 separated by a space
PID: Person IDs of all current household members except specific respondent
FirstName: first names of all current household members except specific respondent
LastName: last names of all current household members except specific respondent

CAG_C01A

If DOCAG = 1, go to CAG_C01B.
Otherwise, go to CAG_END.

CAG_C01B

If PROXMODE = 1, go to CAG_END.
Otherwise, go to CAG_R01.

CAG_R01

(Please refer to page 7 of the booklet.)
The following questions are about the types of assistance you may have provided to people because of a health condition or limitation. Please only include assistance provided to family members, friends and other people living both inside and outside your household. Exclude any assistance you provided as part of a volunteer organization or paid job.
INTERVIEWER : Press <Enter> to continue.

CAG_Q01

During the past 12 months, have you provided any of the following types of assistance to another person because of a health condition or limitation?
INTERVIEWER : Include assistance provided because of physical, mental or cognitive health problems or limitations or because of aging. Read categories to respondent. Mark all that apply.
1 Personal care such as assistance with eating, dressing, bathing, or toileting
2 Medical care such as help taking medicine or help with nursing care (for example, dressing changes or foot care)
3 Managivng care such as making appointments
4 Help with activities such as housework, home maintenance and outdoor work
5 Transportation, such as trips to the doctor or for shopping
6 Meal preparation or delivery
7 Did not provide any assistance (Go to CAG_Q02G)
8 Other – Specify (Go to CAG_S01)
DK , RF (Go to CAG_END)
Go to CAG_C02

CAG_S01

INTERVIEWER : Specify.
(80 spaces)
( DK , RF are not allowed)

CAG_E01

You cannot select "Did not provide any assistance" and another category. Please return and correct.

Note:

Trigger hard edit if CAG_Q01 = 7 and any other response selected in CAG_Q01.

CAG_C02

If more than one type of assistance is indicated in CAG_Q01, go to CAG_Q02A.
Otherwise, go to CAG_Q02E.

CAG_Q02A

For which type of activity did you provide the most assistance?
INTERVIEWER : "Most assistance" can be measured in time or effort; whichever the respondent decides.
1 Personal care such as assistance with eating, dressing, bathing, or toileting
2 Medical care such as help taking medicine or help with nursing care (for example, dressing changes or foot care)
3 Managing care such as making appointments
4 Help with activities such as housework, home maintenance and outdoor work
5 Transportation, such as trips to the doctor or for shopping
6 Meal preparation or delivery
7 ^CAG_S01
RF (Go to CAG_END)
DK
Go to CAG_Q02E

Note:

At the time of the data processing, if the respondent reported only one type of assistance in CAG_Q01, the variable CAG_Q02A will be given its value.

CAG_E02A

An invalid answer item has been selected. Please return and correct.

Note:

Trigger hard edit if the response in CAG_Q02A was not selected in CAG_Q01.

CAG_Q02E

During the past 12 months, did you provide respite care (meaning planned relief or assistance)?
INTERVIEWER : Include all types of assistance previously mentioned.
1 Yes
2 No
DK , RF

CAG_Q02F

During the past 12 months, did you provide palliative care (meaning care given to a person nearing end of life)?
INTERVIEWER : Include all types of assistance previously mentioned.
1 Yes
2 No
DK , RF

CAG_Q02G

During the past 12 months, have you provided financial assistance to anyone because of a health condition or limitation? (For example: paying for medications or a private nurse.)
INTERVIEWER : Including family members, friends and others.
1 Yes
2 No
DK , RF

CAG_C02GA

If (CAG_Q02E = DK or RF ) and (CAG_Q02F = DK or RF ) and (CAG_Q02G = DK or RF ), go to CAG_END.
Otherwise, go to CAG_C02GB.

CAG_C02GB

If CAG_Q01 = 7 (did not provide any assistance), go to CAG_C02GC.
Otherwise, go to CAG_R03A.

CAG_C02GC

If CAG_Q02G = 1 (provided financial assistance), go to CAG_C26.
Otherwise, go to CAG_END.

CAG_R03A

Now we are interested in all of the people you have provided assistance to during the past 12 months. Do not include any assistance you have provided as part of a volunteer organization or as a paid worker.
INTERVIEWER : Press <Enter> to continue.

CAG_Q03A

During the past 12 months, how many people in total have you provided any type of assistance to because of a health condition or limitation, including financial assistance?
INTERVIEWER : Include all forms of assistance, not only financial.
( MIN : 1) ( MAX : 100)
DK , RF

CAG_E03A

An unusual value has been entered. Please return and confirm.

Note:

Trigger soft edit if CAG_Q03A > 10.

CAG_C03A

If CAG_Q03A = RF , go to CAG_END.
Otherwise, go to CAG_D03A.

CAG_D03A

If CAG_Q03A > 1 or CAG_Q03A = DK , DT_MOST = "the most".
Otherwise, DT_MOST = "null".

CAG_R03B

We are interested in finding out a little bit more about the person to whom, in the past 12 months, you have dedicated ^DT_MOST time and resources to assisting.
INTERVIEWER : Press <Enter> to continue.

CAG_Q03B

Is the person to whom you provided ^DT_MOST assistance:
INTERVIEWER : Read categories to respondent. Only select 1 if care recipient is currently living in the household.
1 … living in this household? (Go to CAG_Q03D)
2 … living in another household? (Go to CAG_D04)
3 … living in a health care institution? (Go to CAG_D04)
4 … deceased?
RF (Go to CAG_END)
DK (Go to CAG_R16)

CAG_Q03C

It is important to gather information on people that receive assistance. Would you feel comfortable answering a few questions about this person?
1 Yes (Go to CAG_D04)
2 No (Go to CAG_END)
DK , RF (Go to CAG_END)

CAG_Q03D

What is the name of this person?
INTERVIEWER : Please select the care recipient.
01 ^FirstName1 ^LastName1
02 ^FirstName2 ^LastName2
20 ^FirstName20 ^LastName20
DK , RF not allowed

Note:

Screen display: Display all current members of the household ( PID and FirstName and LastName). Do not display empty lines.

CAG_E03D

An invalid answer has been selected. Please return and correct.

Note:

Trigger hard edit if answer selected in CAG_Q03D is empty.

CAG_D03D

ASST_NAME = CAG_Q03D

CAG_D04

If CAG_Q03B = 4 and CAG_Q03C = 1, DT_IS = "was".
Otherwise, DT_IS = "is".
If CAG_Q03B = 4 and CAG_Q03C = 1, DT_HAVE = "had".
Otherwise, DT_HAVE = "have".
If CAG_Q03B = 4 and CAG_Q03C = 1, DT_ARE = "Were".
Otherwise, DT_ARE = "Are".
If CAG_Q03B = 4 and CAG_Q03C = 1, DT_ISC = "Was".
Otherwise, DT_ISC = "Is".

Note:

At the time of data processing, if the respondent reported that the person cared for lived in the same household as the respondent, then the data on sex, age, and relationship of that person will be copied from the household roster into CAG_Q04, CAG_Q05B, and CAG_06A, respectively.

CAG_C04

If CAG_Q03B = 1 (same household), go to CAG_C06BA.
Otherwise, go to CAG_Q04.

CAG_Q04

^DT_ISC the person to whom you provided ^DT_MOST assistance:
INTERVIEWER : Read categories to respondent.
1 …male?
2 …female?
RF (Go to CAG_END)
DK (Go to CAG_R16)

CAG_Q05A

What ^DT_IS the first name of this person?
(25 spaces)
DK , RF (Go to CAG_R16)

CAG_D05A

ASST_NAME = CAG_Q05A

CAG_Q05B

How old ^DT_IS ^ASST_NAME ?
INTERVIEWER : If deceased, enter the age at the time of death.
years
( MIN : 1) ( MAX : 130)
DK , RF

CAG_C05BA

If CAG_Q05B = DK or RF , go to CAG_C05BB.
Otherwise, go to CAG_Q06A.

CAG_C05BB

If CAG_Q05B = DK , go to CAG_R16.
Otherwise, go to CAG_END.

CAG_Q06A

What ^DT_IS the relationship between you and ^ASST_NAME? ^DT_ISC ^ASST_NAME your:
INTERVIEWER : Read categories to respondent.
01 …husband / wife?
02 … common–law partner?
03 …parent?
04 …child?
05 …sibling?
06 … grandchild?
07 … father–in–law / mother–in–law?
08 … son–in–law / daughter–in–law?
09 … brother–in–law / sister–in–law?
10 …other relative?
11 …friend, neighbour, or other?
RF (Go to CAG_END)
DK (Go to CAG_R16)

CAG_C06BA

If more than one type of assistance is indicated in CAG_Q01, go to CAG_C06BB.
Otherwise, go to CAG_D07A.

CAG_C06BB

If more than one person is indicated in CAG_Q03A, go to CAG_Q06B.
Otherwise, go to CAG_D07A.

CAG_Q06B

(Please refer to page 7 of the booklet.)
Please tell me which type of assistance you provided to ^ASST_NAME during the past 12 months.
INTERVIEWER : Read categories to respondent. Mark all that apply.
1 Personal care such as assistance with eating, dressing, bathing, or toileting
2 Medical care such as help taking medicine or help with nursing care (for example, dressing changes or foot care)
3 Managing care such as making appointments
4 Help with activities such as housework, home maintenance and outdoor work
5 Transportation, such as trips to the doctor or for shopping
6 Meal preparation or delivery
7 ^CAG_S01
DK
RF (Go to CAG_END)
Go to CAG_Q07A

Note:

At the time of the data processing, if the respondent reported only one type of assistance in CAG_Q01, the variable CAG_Q06B will be given its value.

CAG_E06B

An invalid answer item has been selected. Please return and correct.

Note:

Trigger hard edit if the response in CAG_Q06B was not selected in CAG_Q01.

CAG_D07A

(not applicable)

CAG_Q07A

How long ^DT_HAVE you been providing assistance to ^ASST_NAME?
INTERVIEWER : Read categories to respondent.
1 Less than six months
2 Six months to less than one year
3 One year to less than three years
4 Three years to less than five years
5 Five years or more
DK
RF (Go to CAG_END)

CAG_Q07C

During the past 12 months, did you provide assistance to ^ASST_NAME:
INTERVIEWER : Read categories to respondent.
1 … on a regular basis?
2 … occasionally or rarely? (Go to CAG_R16)
DK (Go to CAG_R16)
RF (Go to CAG_END)

CAG_Q07D

(During the past 12 months,) how often did you provide assistance to
^ASST_NAME? Was it:
INTERVIEWER : Read categories to respondent.
1 …daily?
2 …at least once a week?
3 …at least once a month?
4 …less than once a month?
DK (Go to CAG_D08)
RF (Go to CAG_END)

CAG_D07D

If CAG_Q07D = 1, DT_OFTEN = "day".
If CAG_Q07D = 2, DT_OFTEN = "week".
If CAG_Q07D = 3, DT_OFTEN = "month".
If CAG_Q07D = 4 ou DK , DT_OFTEN = "occasion".

CAG_Q07E

(During the past 12 months,) how much time in an average ^DT_OFTEN did you spend assisting ^ASST_NAME with these activities? Was it:
INTERVIEWER : Read categories to respondent.
1 …less than 1 hour?
2 …1 hour to less than 3 hours?
3 …3 hours to less than 5 hours?
4 …5 hours to less than 10 hours?
5 …10 hours or more?
DK
RF (Go to CAG_END)

CAG_D08

(not applicable)

CAG_Q08

What ^DT_IS the main reason why ^ASST_NAME needed your assistance?
INTERVIEWER : Read categories to respondent.
1 A short–term health condition or limitation (lasted or expected to last less than 6 months)
2 A long–term health condition or limitation (lasted or expected to last 6 months or more)
3 Other – Specify
DK , RF

CAG_S08

INTERVIEWER : Specify.
(80 spaces)
DK , RF

CAG_R16

Now we would like to know how providing assistance to others may have affected your daily life. We would like you to think about all types of assistance you provided to any person over the past 12 months.
INTERVIEWER : Press <Enter> to continue. Exclude any assistance provided as part of a volunteer organization or paid job.

CAG_R19

At times, people may find that providing assistance to others can be a positive and rewarding experience, or a difficult and challenging one.
INTERVIEWER : Press <Enter> to continue.

CAG_Q20

During the past 12 months, what would you say was the most positive or rewarding aspect to providing assistance?
INTERVIEWER : Include all types of assistance provided to any person.
1 Feeling closer to the person
2 Personal satisfaction
3 Feeling needed by care recipient
4 Enjoy providing assistance
5 Did not experience any positive or rewarding experiences
6 Other – Specify (Go to CAG_S20)
DK , RF
Go to CAG_Q21

CAG_S20

INTERVIEWER : Specify.
(80 spaces)
DK , RF

CAG_Q21

(During the past 12 months,) what would you say was the most difficult or challenging aspect to providing assistance?
01 Creates stress
02 Fatigue – physical
03 Emotionally demanding
04 Not enough time – for self or family
05 Conflicts with social life activities
06 Financial burden
07 Impacts on family or other relationships
08 Inte RF eres with work
09 Did not experience any difficulties or challenges
10 Other – Specify (Go to CAG_S21)
DK , RF
Go to CAG_Q23A

CAG_S21

INTERVIEWER : Specify.
(80 spaces)
DK , RF

CAG_Q23A

During the past 12 months, has providing assistance caused or worsened any health condition or limitation you may have?
1 Yes
2 No
DK , RF

CAG_Q23B

(During the past 12 months,) if you had not been able to fulfill your caregiving responsibilities, was there another person or organization who could have provided this assistance in your place?
1 Yes
2 No
DK , RF

CAG_Q24

During the past 12 months, while you were providing assistance, did you receive respite care (meaning planned relief or assistance) from any person or organization?
1 Yes
2 No
DK , RF

CAG_Q25A

Because of providing assistance to others, have you ever experienced any impact on work–related activities?
INTERVIEWER : Mark those who left the work force to raise their children as "No".
1 Yes
2 No (Go to CAG_C26)
3 Never entered the workforce (Go to CAG_C26)
DK , RF (Go to CAG_C26)

CAG_Q25B

Did you:
INTERVIEWER : Read categories to respondent.
Mark all that apply.
1 …stop working or retire earlier than planned?
2 …reduce or modify your working hours?
3 …take a less demanding job?
4 …increase work hours or take on additional paid work to help with added expenses?
5 …use your vacation leave, sick leave or personal time to provide assistance?
6 …take a leave of absence without pay to provide assistance?
7 …turn down a job offer or a promotion?
8 Other – Specify (Go to CAG_S25B)
DK , RF
Go to CAG_C26

CAG_S25B

INTERVIEWER : Specify.
(80 spaces)
DK , RF

CAG_C26

If DOCGE = 1, go to CAG_B26.
Otherwise, go to CAG_END.

CAG_B26

Call Care Giving Expenses block (CGE).

CAG_END

Care giving expenses (CGE)

CGE_BEG

Content block
External variables required:
PROXMODE: proxy identifier from the GR block
FNAME: first name of respondent from household block
DOCGE: do block flag from the sample file
ASST_NAME : name of care recipient from CAG block
PE_Q01: first name of specific respondent from USU block
PE_Q02: last name of specific respondent from USU block
Screen display:
Display on header bar PE_Q01 and PE_Q02 separated by a space
CGE_C01A If DOCGE = 1, go to CGE_C01B.
Otherwise, go to CGE_END.
CGE_C01B If PROXMODE = 1, go to CGE_END.
Otherwise, go to CGE_Q01.

CGE_Q01

During the past 12 months, as a result of providing assistance, did you incur any out–of–pocket expenses for which you do not expect to be fully reimbursed?
INTERVIEWER : This refers to the cost associated with providing assistance because of physical, mental or cognitive health problems or limitations or because of aging.
1 Yes
2 No (Go to CGE_END)
DK , RF (Go to CGE_END)

CGE_Q02

During the past 12 months, on average, how much did you spend per month on these out–of–pocket expenses? Was it:
INTERVIEWER : Read categories to respondent.
1 …less than $50?
2 …$50 to less than $100?
3 …$100 to less than $300?
4 …more than $300?
DK , RF

CGE_Q03

(Please refer to page 8 of the booklet.)
Were these expenses incurred as a result of:
INTERVIEWER : Read categories to respondent. Mark all that apply.
1 …purchasing items (such as medications or medical supplies)?
2 …paying for services (such as housekeeping or daycare)?
3 …increases in your expenses (such as additional housing costs or food)?
4 … transportation (such as gas or parking)?
5 Other – Specify (Go to CGE_S03)
DK , RF
Go to CGE_Q04

CGE_S03

INTERVIEWER : Specify.
(80 spaces)
DK , RF

CGE_Q04

During the past 12 months, have you received any financial assistance to help cover these expenses?
INTERVIEWER : Include reimbursements from insurance companies or government programs that covered all or part of the expenses.
1 Yes
2 No (Go to CGE_END)
DK , RF (Go to CGE_END)

CGE_Q05

From whom did you receive financial assistance? Was it:
INTERVIEWER : Read categories to respondent. Mark all that apply.
1 …^ASST_NAME or another person you provided assistance to?
2 …a private or employer–sponsored insurance plan?
3 …a government program such as tax reduction or welfare?
4 …a family member?
5 Other – Specify (Go to CGE_S05)
DK , RF
Go to CGE_END

CGE_S05

INTERVIEWER : Specify.
(80 spaces)
DK , RF

CGE_END

Depression (DEP)

DEP_BEG Content block

External variables required:
PROXMODE: proxy identifier from the GR block
FNAME: first name of respondent from household component
DODEP: do block flag from the sample file
RESPGENDER: sex of selected respondent from household component
PE_Q01: first name of specific respondent from USU block
PE_Q02: last name of specific respondent from USU block
Screen display:
Display on header bar PE_Q01 and PE_Q02 separated by a space

DEP_C01

If DODEP block = 1, go to DEP_C02.
Otherwise, go to DEP_END.

DEP_C02

If PROXMODE = 1, go to DEP_END.
Otherwise, go to DEP_Q02.

DEP_R01

The following questions deal with feelings you may have had during the past 12 months.
INTERVIEWER : Press <Enter> to continue.

DEP_Q02

During the past 12 months, was there ever a time when you felt sad, blue, or depressed for 2 weeks or more in a row?
1 Yes
2 No (Go to DEP_Q16)
DK , RF (Go to DEP_END)

DEP_Q03

For the next few questions, please think of the 2–week period during the past 12 months when these feelings were the worst. During that time, did these feelings usually last:
INTERVIEWER : Read categories to respondent.
1 … all day long?
2 … most of the day?
3 … about half of the day? (Go to DEP_Q16)
4 … less than half of a day? (Go to DEP_Q16)
DK , RF (Go to DEP_END)

DEP_Q04

How often did you feel this way during those 2 weeks?
INTERVIEWER : Read categories to respondent.
1 Every day
2 Almost every day
3 Less often (Go to DEP_Q16)
DK , RF (Go to DEP_END)

DEP_Q05

During those 2 weeks did you lose interest in most things?
1 Yes
2 No
DK , RF (Go to DEP_END)

DEP_Q06

Did you feel tired out or low on energy all of the time?
1 Yes
2 No
DK , RF (Go to DEP_END)

DEP_Q07

Did you gain weight, lose weight or stay about the same?
1 Gained weight
2 Lost weight
3 Stayed about the same (Go to DEP_Q09)
4 Was on a diet (Go to DEP_Q09)
DK , RF (Go to DEP_END)

DEP_D08A

If DEP_Q07 = 1, DT_GAINLOSE = "gain".
Otherwise, DT_GAINLOSE = "lose".

DEP_Q08A

About how much did you ^DT_GAINLOSE?
INTERVIEWER : Enter amount only.
Weight
( MIN : 1) ( MAX : 99)
DK , RF (Go to DEP_Q09)

DEP_N08A

INTERVIEWER : Was that in pounds or in kilograms?
1 Pounds
2 Kilograms
( DK , RF are not allowed)

DEP_E08A

An unusual value has been entered. Please confirm.

Note:

Trigger soft edit if ((DEP_Q08A > 20 and DEP_N08A = 1) or (DEP_Q08A > 9 and DEP_N08A = 2)).

DEP_Q09

Did you have more trouble falling asleep than you usually do?
1 Yes
2 No (Go to DEP_Q11)
DK , RF (Go to DEP_END)

DEP_Q10

How often did that happen?
INTERVIEWER : Read categories to respondent.
1 Every night
2 Nearly every night
3 Less often
DK , RF (Go to DEP_END)

DEP_Q11

Did you have a lot more trouble concentrating than usual?
1 Yes
2 No
DK , RF (Go to DEP_END)

DEP_Q12

At these times, people sometimes feel down on themselves, no good or worthless. Did you feel this way?
1 Yes
2 No
DK , RF (Go to DEP_END)

DEP_Q13

Did you think a lot about death – either your own, someone else’s or death in general?
1 Yes
2 No
DK , RF (Go to DEP_END)

DEP_C14

If DEP_Q05 = 1 or DEP_Q06 =1 or DEP_Q09=1 or DEP_Q11 = 1 or DEP_Q12 =1 or DEP_Q13 = 1 or DEP_Q07 is in (1,2) ("gain" or "lose"), go to DEP_D14A.
Otherwise, go to DEP_END.

DEP_D14A

If DEP_Q05 = 1, DEP_KP5E = "losing interest".
If DEP_Q06 = 1, DEP_KP6E = "feeling tired".
If DEP_Q07 = 1, DEP_KP7E = "gaining weight".
If DEP_Q07 = 2, DEP_KP7E = "losing weight".
If DEP_Q09 = 1, DEP_KP9E = "trouble falling asleep".
If DEP_Q11 = 1, DEP_KP11E = "trouble concentrating".
If DEP_Q12 = 1, DEP_KP12E = "feeling down on yourself".
If DEP_Q13 = 1, DEP_KP13E = "thoughts about death".

DEP_D14B

If DEP_KP5E is not null, Text1E = "^DEP_KP5E".
If DEP_KP5E is not null, DV_C = "DV_C + 1".
If DEP_KP6E is not null and Text1E is not null, Text1E = "^TEXT1E, ^DEP_KP6E".
If DEP_KP6E is not null and Text1E is null, Text1E = "^DEP_KP6E".
If DEP_KP6E is not null, DV_C = "DV_C + 1".
If DEP_KP7E is not null and Text1E is not null, Text1E = "^TEXT1E, ^DEP_KP7E".
If DEP_KP7E is not null and Text1E is null, Text1E = "^DEP_KP7E".
If DEP_KP7E is not null, DV_C = "DV_C + 1".
If DEP_KP9E is not null and Text1E is not null and DV_C <3, Text1E = "^Text1E, ^DEP_KP9E".
If DEP_KP9E is not null and Text1E is null, Text1E = "^DEP_KP9E".
If DEP_KP9E is not null and DV_C < 3, DV_C = "DV_C + 1".
If DEP_KP11E is not null and Text1E is not null and DV_C <3, Text1E = "^Text1E, ^DEP_KP11E".
If DEP_KP11E is not null and Text1E is null, Text1E = "^DEP_KP11E".
If DEP_KP11E is not null and DV_C < 3, DV_C = "DV_C + 1".
If DEP_KP12E is not null and Text1E is not null and DV_C <3, Text1E = "^Text1E, ^DEP_KP12E".
If DEP_KP12E is not null and Text1E is null, Text1E = "^DEP_KP12E".
If DEP_KP12E is not null and DV_C < 3, DV_C = "DV_C + 1".
If DEP_KP13E is not null and Text1E is not null and DV_C <3, Text1E = "^Text1E, ^DEP_KP13E".
If DEP_KP13E is not null and Text1E is null, Text1E = " ^DEP_KP13E".
If DEP_KP13E is not null and DV_C < 3, DV_C = "DV_C + 1".

DEP_R14

Reviewing what you just told me, you had 2 weeks in a row during the past 12 months when you were sad, blue or depressed and also had some other things like ^Text1E.
INTERVIEWER : Press <Enter> to continue.

DEP_Q14

About how many weeks altogether did you feel this way during the past 12 months?
Weeks
( MIN : 2) ( MAX : 53)
DK , RF (Go to DEP_END)

DEP_C15

If DEP_Q14 > 51 weeks, go to DEP_END.
Otherwise, go to DEP_Q15.

DEP_Q15

Think about the last time you felt this way for 2 weeks or more in a row. In what month was that?
01 January
02 February
03 March
04 April
05 May
06 June
07 July
08 August
09 September
10 October
11 November
12 December
DK , RF
Go to DEP_END

DEP_Q16

During the past 12 months, was there ever a time lasting 2 weeks or more when you lost interest in most things like hobbies, work or activities that usually give you pleasure?
1 Yes
2 No (Go to DEP_END)
DK , RF (Go to DEP_END)

DEP_Q17

For the next few questions, please think of the 2 – week period during the past 12 months when you had the most complete loss of interest in things. During that 2 – week period, how long did the loss of interest usually last?
INTERVIEWER : Read categories to respondent.
1 All day long
2 Most of the day
3 About half of the day (Go to DEP_END)
4 Less than half of a day (Go to DEP_END)
DK , RF (Go to DEP_END)

DEP_Q18

How often did you feel this way during those 2 weeks?
INTERVIEWER : Read categories to respondent.
1 Every day
2 Almost every day
3 Less often (Go to DEP_END)
DK , RF (Go to DEP_END)

DEP_Q19

During those 2 weeks did you feel tired out or low on energy all the time?
1 Yes
2 No
DK , RF (Go to DEP_END)

DEP_Q20

Did you gain weight, lose weight, or stay about the same?
1 Gained weight
2 Lost weight
3 Stayed about the same (Go to DEP_Q22)
4 Was on a diet (Go to DEP_Q22)
DK , RF (Go to DEP_END)

DEP_D21A

If DEP_Q20 = 1, DT_GAINLOSE2 = "gain".
Otherwise, DT_GAINLOSE2 = "lose".

DEP_Q21A

About how much did you ^DT_GAINLOSE2?
INTERVIEWER : Enter amount only.
Weight
( MIN : 1) ( MAX : 99)
DK , RF (Go to DEP_Q22)

DEP_N21A

INTERVIEWER : Was that in pounds or in kilograms?
1 Pounds
2 Kilograms
( DK , RF are not allowed)

DEP_E21A

An unusual value has been entered. Please confirm.

Note:

Trigger soft edit if ((DEP_Q21A > 20 and DEP_N21A = 1) or (DEP_Q21A > 9 and DEP_N21A = 2)).

DEP_Q22

Did you have more trouble falling asleep than you usually do?
1 Yes
2 No (Go to DEP_Q24)
DK , RF (Go to DEP_END)

DEP_Q23

How often did that happen?
INTERVIEWER : Read categories to respondent.
1 Every night
2 Nearly every night
3 Less often
DK , RF (Go to DEP_END)

DEP_Q24

Did you have a lot more trouble concentrating than usual?
1 Yes
2 No
DK , RF (Go to DEP_END)

DEP_Q25

At these times, people sometimes feel down on themselves, no good, or worthless.
Did you feel this way?
1 Yes
2 No
DK , RF (Go to DEP_END)

DEP_Q26

Did you think a lot about death – either your own, someone else’s, or death in general?
1 Yes
2 No
DK , RF (Go to DEP_END)

DEP_C27

If DEP_Q19 = 1 or DEP_Q22 = 1 or DEP_Q24 = 1 or DEP_Q25 = 1 or DEP_Q26 = 1 or DEP_Q20 is in (1,2) ("gain" or "lose"), go to DEP_D27A.
Otherwise, go to DEP_END.

DEP_D27A

If DEP_Q19 = 1, DEP_KP19E = "feeling tired".
If DEP_Q20 = 1, DEP_KP20E = "gaining weight".
If DEP_Q20 = 2, DEP_KP20E = "losing weight".
If DEP_Q22 = 1, DEP_KP22E = "trouble falling asleep".
If DEP_Q24 = 1, DEP_KP24E = "trouble concentrating".
If DEP_Q25 = 1, DEP_KP25E = "feeling down on yourself".
If DEP_Q26 = 1, DEP_KP26E = "thoughts about death".

DEP_D27B

If DEP_KP19E is not null, Text2E = "^DEP_KP19E".
If DEP_KP19E is not null, DV_C = "DV_C + 1".
If DEP_KP20E is not null and Text2E is not null, Text2E = "^TEXT2E, ^DEP_KP20E".
If DEP_KP20E is not null and Text2E is null, Text2E = "^DEP_KP20E".
If DEP_KP20E is not null, DV_C = "DV_C + 1".
If DEP_KP22E is not null and Text2E is not null and DV_C <3, Text2E = "^Text2E, ^DEP_KP22E".
If DEP_KP22E is not null and Text2E is null, Text2E = "^DEP_KP22E".
If DEP_KP22E is not null and DV_C < 3, DV_C = "DV_C + 1".
If DEP_KP24E is not null and Text2E is not null and DV_C <3, Text2E = "^Text2E, ^DEP_KP24E".
If DEP_KP24E is not null and Text2E is null, Text2E = "^DEP_KP24E".
If DEP_KP24E is not null and DV_C < 3, DV_C = "DV_C + 1".
If DEP_KP25E is not null and Text2E is not null and DV_C <3, Text2E = "^Text2E, ^DEP_KP25E".
If DEP_KP25E is not null and Text2E is null, Text2E = "^DEP_KP25E".
If DEP_KP25E is not null and DV_C < 3, DV_C = "DV_C + 1".
If DEP_KP26E is not null and Text2E is not null and DV_C <3, Text2E = "^Text2E, ^DEP_KP26E".
If DEP_KP26E is not null and Text2E is null, Text2E = " ^DEP_KP26E".
If DEP_KP26E is not null and DV_C < 3, DV_C = "DV_C + 1".

DEP_R27

Reviewing what you just told me, you had 2 weeks in a row during the past 12 months when you lost interest in most things and also had some other things like ^Text2E.
INTERVIEWER : Press <Enter> to continue.

DEP_Q27

About how many weeks did you feel this way during the past 12 months?
Weeks
( MIN : 2) ( MAX : 53)
DK , RF (Go to DEP_END)

DEP_C28

If DEP_Q27 > 51, go to DEP_END.
Otherwise, go to DEP_Q28.

DEP_Q28

Think about the last time you had 2 weeks in a row when you felt this way. In what month was that?
01 January
02 February
03 March
04 April
05 May
06 June
07 July
08 August
09 September
10 October
11 November
12 December
DK , RF

DEP_END

Loneliness (LON)

LON_BEG

This module is the 3–Item Loneliness Scale developed by Dr. Mary Elizabeth Hughes (Johns Hopkins Bloomberg School of Public Health). The author granted permission to Statistics Canada for the use of the 3–Item Loneliness Scale in this survey.
Content block
External variables required:
PROXMODE: proxy identifier from the GR block
FNAME: first name of respondent from household component
DOLON: do block flag from the sample file
PE_Q01: first name of specific respondent from USU block
PE_Q02: last name of specific respondent from USU block
Screen display:
Display on header bar PE_Q01 and PE_Q02 separated by a space

LON_C01A

If DOLON = 1, go to LON_C01B.
Otherwise, go to LON_END.

LON_C01B

If PROXMODE = 1, go to LON_END.
Otherwise, go to LON_R01.

LON_R01

The next questions are about how you feel about different aspects of your life.
For each one, tell me how often you feel that way.
INTERVIEWER : Press <Enter> to continue.

LON_Q01

How often do you feel that you lack companionship?
INTERVIEWER : Read categories to respondent.
If respondent says "Never", code as "Hardly ever".
1 Hardly ever
2 Some of the time
3 Often
DK , RF

LON_Q02

How often do you feel left out?
INTERVIEWER : Read categories to respondent.
If respondent says "Never", code as "Hardly ever".
1 Hardly ever
2 Some of the time
3 Often
DK , RF

LON_Q03

How often do you feel isolated from others?
INTERVIEWER : Read categories to respondent.
If respondent says "Never", code as "Hardly ever".
1 Hardly ever
2 Some of the time
3 Often
DK , RF

LON_END

Transportation (TRA)

TRA_BEG

Content block
External variables required:
PE_Q01: first name of specific respondent from USU block
PE_Q02: last name of specific respondent from USU block
PROXMODE: proxy identifier from the GR block.
FNAME: first name of respondent from household block.
DOTRA: do block flag from the sample file
Screen display :
Display on header bar PE_Q01 and PE_Q02 separated by a space

TRA_C01

If DOTRA = 1, go to TRA_R01.
Otherwise, go to TRA_END.

TRA_R01

Now some questions about transportation.
INTERVIEWER : Press <Enter> to continue.

TRA_Q01

^DOVERB_C ^YOU2 have a valid driver’s license? (Include cars, vans, trucks and motorcycles.)
INTERVIEWER : This includes a driver’s license where an individual is permitted to drive alone with some restrictions, e.g. zero blood alcohol level.
1 Yes
2 No (Go to TRA_D03)
DK , RF (Go to TRA_END)

TRA_Q02

In the past month, how often did ^YOU1 drive? Was it:
INTERVIEWER : Read categories to respondent.
1 ... 6 or 7 days a week?
2 ... 4 or 5 days a week?
3 ... 1 to 3 days a week?
4 ... 1 to 3 days in the past month?
5 ... Not at all in the past month?
DK , RF

TRA_D03

If TRA_Q01 = 2 or TRA_Q02 = 5, DT_OTHE RF ORMS = "forms".
Otherwise, DT_OTHE RF ORMS = "other forms".

TRA_Q03

In the past month, which of the following ^DT_OTHE RF ORMS of transportation ^HAVE ^YOU1 used?
INTERVIEWER : For the public transportation category, include respondents who travel by vehicle to another area in order to use public transportation (e.g., travelling to a "park and ride").
Accessible transit includes any accessible transportation service specifically designed for persons with disabilities or mobility issues, such as "Para Transpo", "Handi Transit", or "Wheel Trans".
Read categories to respondent.
Mark all that apply.
1 Passenger in a motor vehicle
2 Taxi
3 Public transportation such as bus, rapid transit, (Go to TRA_C03B) subway or train
4 Accessible transit
5 Cycling
6 Walking
7 Wheelchair or motorized cart
8 None
DK , RF (Go to TRA_END)

TRA_E03

You cannot select "None" and another category. Please return and correct.

Note:

Trigger hard edit if TRA_Q03 = 8 is chosen with any other response.

TRA_Q03A

Why did ^YOU1 not use public transportation?
INTERVIEWER : Read categories to respondent.
Mark all that apply.
1 Service not needed
2 Prefer not to use
3 Service unavailable in ^YOUR1 area
4 Limitation due to a health condition
5 Inconvenient service schedule or route
6 Too costly
7 Other – Specify (Go to TRA_S03A)
DK , RF
Go to TRA_C03B

TRA_S03A

INTERVIEWER : Specify.
(80 spaces)
DK , RF

TRA_C03B

If TRA_Q03 = 4 (Accessible transit), go to TRA_C04.
Otherwise, go to TRA_Q03B.

TRA_Q03B

Why did ^YOU1 not use accessible transit?
INTERVIEWER : Accessible transit includes any accessible transportation service specifically designed for persons with disabilities or mobility issues, such as "Para Transpo", "Handi Transit", or "Wheel Trans".
Read categories to respondent.
Mark all that apply.
1 Service not needed
2 Prefer not to use
3 Service unavailable in ^YOUR1 area
4 Limitation due to a health condition
5 Inconvenient service schedule or route
6 Too costly
7 Other – Specify (Go to TRA_S03B)
DK , RF
Go to TRA_C04

TRA_S03B

INTERVIEWER : Specify.
(80 spaces)
DK , RF

TRA_C04

If (TRA_Q02 = 1 to 4 and TRA_Q03 = at least one of 1 to 7) or ((TRA_Q01 = 2 or TRA_Q02 = 5, DK , RF ) and TRA_Q03 = at least two of 1 to 7)), go to TRA_Q04.
Otherwise, go to TRA_END.

TRA_Q04

In general, which is ^YOUR2 most common form of transportation?
INTERVIEWER : Read categories to respondent.
1 Passenger in a motor vehicle
2 Taxi
3 Public transportation such as bus, rapid transit, subway or train
4 Accessible transit
5 Cycling
6 Walking
7 Wheelchair or motorized cart
8 Drive a motor vehicle
DK , RF

TRA_E04

Inconsistent answers have been entered. The respondent has given a most common mode of transportation that is not included in previous questions on mode of transportation. Please verify.

Note:

Trigger hard edit if (answer in TRA_Q04 (1 to 7) is not in TRA_Q03) or if ((TRA_Q01 = 2 or TRA_Q02 = 5, DK or R) and TRA_Q04 = 8).

TRA_END

Labour force (LBF)

LBF_BEG

Content block
External variables required:
SEX_Q01: sex of specific respondent (1 = male, 2 = female) from Sex block
PROXMODE: proxy identifier from the GR block
FNAME: first name of respondent from household block
DOLBF: do block flag from the sample file
CURRAGE: current age of respondent from AN2 block
GEN_Q08: work in the last 12 months from GEN block
REFDATE : system date

LBF_C01A

If DOLBF = 1, go to LBF_C01B.
Otherwise, go to LBF_END.

LBF_C01B

If CURRAGE > 74, go to LBF_END.
Otherwise, go to LBF_D01.

LBF_D01

DATEONEYEARAGO = (REFDATE – 1 year)
DATEYESTERDAY = (REFDATE – 1 day)
DATEONEWEEKAGO = (REFDATE – 1 week)

LBF_R01

The next few questions concern ^YOUR2 activities in the last 7 days. By the last 7 days, I mean beginning ^DATEONEWEEKAGO, and ending ^DATEYESTERDAY.
INTERVIEWER : Press <Enter> to continue.

LBF_Q01

Last week, did ^YOU2 work at a job or a business? Please include part–time jobs, seasonal work, contract work, self–employment, baby–sitting and any other paid work, regardless of the number of hours worked.
1 Yes (Go to LBF_Q04)
2 No (Go to LBF_Q02)
3 Permanently unable to work (Go to LBF_C02A)
DK , RF (Go to LBF_END)

LBF_E01

A response inconsistent with a response to a previous question has been entered.
Please confirm.

Note:

Trigger soft edit if GEN_Q08 = 2 (did not work at any time in the past 12 months) and LBF_Q01 = 1.

LBF_C02A

If GEN_Q08 = 2, go to LBF_Q03.
Otherwise, go to LBF_Q11.

LBF_Q02

Last week, did ^YOU2 have a job or business from which ^YOU1 ^WERE absent?
1 Yes (Go to LBF_Q04)
2 No (Go to LBF_Q03)
DK , RF (Go to LBF_END)

LBF_Q03

^HAVE_C ^YOU2 ever worked at a job or business?
1 Yes (Go to LBF_Q11)
2 No (Go to LBF_END)
DK , RF (Go to LBF_Q11)

LBF_Q04

Did ^YOU1 have more than one job or business last week?
1 Yes
2 No
DK , RF
Go to LBF_D31A

LBF_Q11

In the past 4 weeks did ^YOU2 do anything to find work?
1 Yes (Go to LBF_R21)
2 No
DK , RF (Go to LBF_R21)

LBF_Q13A

What is the main reason that ^YOU1 ^ARE not currently working at a job or business?
01 Own illness or disability (Go to LBF_Q13B)
02 Caring for – own children
03 Caring for – elder relatives
04 Pregnancy (females only)
05 Other personal or family responsibilities
06 Vacation
07 School or educational leave
08 Retired
09 Believes no work available (in area or suited to skills)
10 Other – Specify (Go to LBF_S13A)
DK , RF
Go to LBF_R21

LBF_E13A

A response of "Pregnancy" is invalid for a male respondent. Please return and correct.

Note:

Trigger hard edit (SEX_Q01 = 1 (male)) and (LBF_Q13A = 4).

LBF_S13A

INTERVIEWER : Specify.
(80 spaces)
DK , RF
Go to LBF_R21

LBF_Q13B

Is this due to ^YOUR1 physical health, to ^YOUR1 emotional or mental health, to ^YOUR1 use of alcohol or drugs, or to another reason?
1 Physical health
2 Emotional or mental health (including stress)
3 Use of alcohol or drugs
4 Another reason
DK , RF

LBF_R21

Now some questions about jobs or employment which ^YOU2 ^HAVE had during the past 12 months, that is, from ^DATEONEYEARAGO to yesterday.
INTERVIEWER : Press <Enter> to continue.

LBF_Q21

Did ^YOU1 work at a job or a business at any time in the past 12 months? Please include part–time jobs, seasonal work, contract work, self–employment, baby–sitting and any other paid work, regardless of the number of hours worked.
1 Yes (Go to LBF_Q23)
2 No
DK , RF (Go to LBF_END)

LBF_E21

A response inconsistent with a response to a previous question has been entered.
Please confirm.

Note:

If (GEN_Q08 = 2 (has not worked in the past 12 months) and LBF_Q21 = 1) or if (GEN_Q08 = 1 (worked in past 12 months) and LBF_Q21 = 2).

LBF_C22

If LBF_Q11 = 1 (did something to find work in last 4 weeks), go to LBF_D70B.
Otherwise, go to LBF_Q22.

LBF_Q22

During the past 12 months, did ^YOU1 do anything to find work?
1 Yes (Go to LBF_D70B)
2 No (Go to LBF_END)
DK , RF (Go to LBF_END)

LBF_Q23

During that 12 months, did ^YOU1 work at more than one job or business at the same time?
1 Yes
2 No
DK , RF

LBF_D31A

If LBF_Q01 = 1 or LBF_Q02 = 1, DT_AREC = "^ARE_C".
Otherwise, DT_AREC = "^WERE_C".
If LBF_Q01 = 1 or LBF_Q02 = 1, DT_ISWAS = "is".
Otherwise, DT_ISWAS = "was".
If LBF_Q01 = 1 or LBF_Q02 = 1, DT_WORK = "^WORK".
Otherwise, DT_WORK = "worked".
If LBF_Q01 = 1 or LBF_Q02 = 1, DT_AREWERE = "^ARE".
Otherwise, DT_AREWERE = "^WERE".
If LBF_Q01 = 1 or LBF_Q02 = 1, DT_DODIDC = "^DOVERB_C".
Otherwise, DT_DODIDC = "Did".
If LBF_Q01 = 1 or LBF_Q02 = 1, DT_CURLAST = "currently".
Otherwise, DT_CURLAST = "last".
If LBF_Q01 = 1 or LBF_Q02 = 1, DT_DODID = "^DOVERB".
Otherwise, DT_DODID = "did".
If LBF_Q01 = 1 or LBF_Q02 = 1, DT_AREWERE2 = "are".
Otherwise, DT_AREWERE2 = "were".
If LBF_Q01 = 1 or LBF_Q02 = 1, DT_CURLAST2 = "current".
Otherwise, DT_CURLAST2 = "last".

LBF_Q31A

^DT_AREC ^YOU1 an employee or self–employed?
INTERVIEWER : If respondent holds or held more than one job, report on the job forwhich the number of hours worked per week is or was the greatest.
1 Employee (Go to LBF_Q33)
2 Self–employed
3 Working in a family business without pay (Go to LBF_Q33)
DK , RF (Go to LBF_Q33)

LBF_Q31B

^DT_DODIDC ^YOU1 have any employees?
1 Yes
2 No
DK , RF

LBF_Q32

What ^DT_ISWAS the name of ^YOUR1 business?
(50 spaces)
DK , RF
Go to LBF_Q34

LBF_Q33

For whom ^DT_DODID ^YOU1 ^DT_CURLAST work? (For example: name of business, government department or agency, or person.)
(50 spaces)
DK , RF

LBF_Q34

What kind of business, industry or service ^DT_ISWAS this? (For example: cardboard box manufacturing, road maintenance, retail shoe store, secondary school, dairy farm, municipal government.)
(50 spaces)
DK , RF

LBF_Q35

What kind of work ^DT_AREWERE ^YOU1 doing? (For example: babysitting in own home, factory worker, forestry technician.)
(50 spaces)
DK , RF

LBF_D35

SOC_CODE (4 bytes)

Note:

Store SOC_CODE associated with LBF_Q35.

LBF_C35

If LBF_D35 = 1 (Other – specify) or LBF_D35 = 2 (Autre – Précisez), go to LBF_S35.
Otherwise, go to LBF_Q36.

LBF_S35

INTERVIEWER : Specify.
(80 spaces)
DK , RF

LBF_Q36

What ^DT_AREWERE2 ^YOUR1 most important activities or duties? (For example: caring for children, stamp press machine operator, forest examiner.)
(50 spaces)
DK , RF

LBF_Q37

^DT_ISWAS_C ^YOUR1 job permanent, or is there some way that it ^DT_ISWAS not permanent? (For example: seasonal, temporary, term, casual.)
1 Permanent (Go to LBF_C41)
2 Not permanent
DK , RF (Go to LBF_C41)

LBF_Q38

In what way ^DT_ISWAS ^YOUR1 job not permanent?
1 Seasonal
2 Temporary, term or contract
3 Casual job
4 Work done through a temporary help agency
5 Other
DK , RF

LBF_C41

If LBF_Q02 = 1 (were absent from work), go to LBF_Q41.
Otherwise, go to LBF_D43.

LBF_Q41

What was the main reason ^YOU2 ^WERE absent from work last week?
01 Own illness or disability (Go to LBF_Q42)
02 Caring for – own children
03 Caring for – elder relatives
04 Maternity leave (females only)
05 Other personal or family responsibilities
06 Vacation
07 Labour dispute (strike or lockout)
08 Temporary layoff due to business conditions (employees only)
09 Seasonal layoff (employees only)
10 Casual job, no work available (employees only)
11 Work schedule (for example, shift work employees only)
12 Self–employed, no work available (self–employed only)
13 Seasonal business (excluding employees)
14 School or educational leave
15 Other – Specify (Go to LBF_S41)
DK , RF
Go to LBF_D43

LBF_S41

INTERVIEWER : Specify.
(80 spaces)
DK , RF
Go to LBF_D43

LBF_E41A

A response of "Maternity leave" is invalid for a male respondent. Please return and correct.

Note:

Trigger hard edit if SEX_Q01 = 1 and LBF_Q41 = 4.

LBF_E41B

A response of "Self–employed, no work available" or "Seasonal business" is invalid for an employee. Please return and correct.

Note:

Trigger hard edit if LBF_Q31A = 1 and (LBF_Q41 = 12 or 13).

LBF_E41C

A response of "Temporary layoff due to business conditions", "Seasonal layoff", "Casual job, no work available" or "Work schedule" is invalid for a self–employed person. Please return and correct.

Note:

Trigger hard edit if LBF_Q31A = 2 and (LBF_Q41 = 8, 9, 10 or 11).

LBF_E41D

A response of "Temporary layoff due to business conditions", "Seasonal layoff", "Casual job, no work available", "Work schedule" or "Self–employed, no work available" is invalid for a person working in a family business without pay. Please return and correct.

Note:

Trigger hard edit if (LBF_Q31A = 3) and (LBF_Q41 = 8, 9, 10, 11 or 12).

LBF_Q42

Was that due to ^YOUR1 physical health, to ^YOUR1 emotional or mental health, to ^YOUR1 use of alcohol or drugs, or to another reason?
1 Physical health
2 Emotional or mental health (including stress)
3 Use of alcohol or drugs
4 Another reason
DK , RF

LBF_D43

If LBF_Q31A = 1, DT_JOB = "job".
Otherwise, DT_JOB = "business".

LBF_Q43

About how many hours a week ^DT_DODID ^YOU2 usually work at ^YOUR1 ^DT_JOB? If ^YOU1 usually ^DT_WORK extra hours, paid or unpaid, please include these hours.
Hours
( MIN : 1) ( MAX : 168warning after 84)
DK , RF

LBF_Q44

Which of the following best describes the hours ^YOU2 usually ^DT_WORK at ^YOUR1 ^DT_JOB?
INTERVIEWER : Read categories to respondent.
1 Regular – daytime schedule or shift (Go to LBF_Q46A)
2 Regular – evening shift
3 Regular – night shift
4 Rotating shift (change from days to evenings to nights)
5 Split shift
6 On call
7 Irregular schedule
8 Other – Specify (Go to LBF_S44)
DK , RF (Go to LBF_Q46A)
Go to LBF_Q45

LBF_S44

INTERVIEWER : Specify.
(80 spaces)
DK , RF

LBF_Q45

What is the main reason that ^YOU1 ^WORK this schedule?
1 Requirement of job / no choice
2 Going to school
3 Caring for – own children
4 Caring for – other relatives
5 To earn more money
6 Likes to work this schedule
7 Other – Specify (Go to LBF_S45)
DK , RF
Go to LBF_Q46A

LBF_S45

INTERVIEWER : Specify.
(80 spaces)
DK , RF

LBF_Q46A

^DT_DODID ^YOU1 usually work on weekends at this ^DT_JOB?
1 Yes
2 No
DK , RF

LBF_Q46B

In ^YOUR1 ^DT_CURLAST2 ^DT_JOB, ^DT_AREWERE2 there opportunities to work, either full time or part time after age 65?
1 Yes
2 No
DK , RF

LBF_C51

If LBF_Q04 = 1 or LBF_Q23 = 1, go to LBF_D51.
Otherwise, go to LBF_Q61.

LBF_D51

If LBF_Q04 = 1, DT_HAVE1 = "^HAVE".
If LBF_Q23 = 1, DT_HAVE1 = "had".
If LBF_Q04 = 1, DT_HAVE2 = "^HAVE".
If LBF_Q23 = 1, DT_HAVE2 = "did".
If LBF_Q04 = 1, DT_WORKED = "worked".
If LBF_Q23 = 1, DT_WORKED = "work".

LBF_Q51

You indicated that ^YOU2 ^DT_HAVE1 more than one job. For how many weeks in a row ^DT_HAVE2 ^YOU1 ^DT_WORKED at more than one job (in the past 12 months)?
INTERVIEWER : Obtain best estimate.
Weeks
( MIN : 1) ( MAX : 52)
DK , RF

LBF_Q52

What is the main reason that ^YOU1 ^DT_WORK at more than one job?
1 To meet regular household expenses
2 To pay off debts
3 To buy something special
4 To save for the future
5 To gain experience
6 To build up a business
7 Enjoys the work of the second job
8 Other – Specify (Go to LBF_S52)
DK , RF
Go to LBF_D53

LBF_S52

INTERVIEWER : Specify.
(80 spaces)
DK , RF

LBF_D53A

DV_OTHHRS = 168 – LBF_Q43

LBF_D53B

If LBF_Q43 = ( DK , RF ) , MAXVAL = 168
If LBF_Q43 = 168, MAXVAL = 1
Otherwise, MAXVAL = DV_OTHHRS

LBF_Q53

About how many hours a week ^DT_DODID ^YOU1 usually work at ^YOUR1 other job(s)? If ^YOU1 usually ^DT_WORK extra hours, paid or unpaid, please include these hours.
INTERVIEWER : minimum is 1; maximum is ^DV_OTHHRS.
Hours
( MIN : 1) ( MAX : ^MAXVAL: warning after 30)
DK , RF

LBF_E53_1

The indicated length of time is outside of the range. Please return and correct.

Note:

Trigger hard edit if (LBF_Q53 > DV_OTHHRS).

LBF_E53_2

An unusual value has been entered. Please confirm.

Note:

Trigger soft edit if (LBF_Q53 > 30).

LBF_Q54

^DT_DODIDC ^YOU1 usually work on weekends at ^YOUR1 other job(s)?
1 Yes
2 No
DK , RF

LBF_Q61

During the past 52 weeks, how many weeks did ^YOU2 do any work at a job or a business? (Include paid vacation leave, paid maternity leave, and paid sick leave.)
Weeks
( MIN : 1) ( MAX : 52)
DK , RF (Go to LBF_D70B)

LBF_E61

The number of weeks at which the respondent was working at more than one job or business is greater than the number of weeks the respondent was doing any work at a job or business. Please return and correct.

Note:

Trigger hard edit if LBF_Q51 > LBF_Q61.

LBF_D61

DV_REMWK = (52 – LBF_Q61(weeks worked))

LBF_C70A

If DV_REMWK = 0, go to LBF_END.
Otherwise, go to LBF_C70B.

LBF_C70B

If DV_REMWK = 1, go to LBF_Q71C.
Otherwise, go to LBF_D71A.

LBF_D70B

DV_REMWK = 52

LBF_D71A

If LBF_Q61 = ( DK , RF ) or LBF_Q21 = 2, LBF_EXTRA = "During the past 52 weeks, how many weeks ^WERE ^YOU1 looking for work?".Otherwise, LBF_EXTRA = "That leaves ^DV_REMWK weeks. During those ^DV_REMWK weeks, how many weeks ^WERE ^YOU1 looking for work?".

LBF_Q71A

^LBF_EXTRA
INTERVIEWER : minimum is 0; maximum is ^DV_REMWK.
Weeks
( MIN : 0) ( MAX : ^DV_REMWK)
DK , RF

LBF_C71A

If LBF_Q61 = ( DK , RF ) or LBF_Q71A = ( DK , RF ), go to LBF_END.
Otherwise, go to LBF_C71B.

LBF_C71B

If LBF_Q71A = DV_REMWK, go to LBF_END.
Otherwise, go to LBF_D72A.

LBF_Q71C

That leaves 1 week. During that week, did ^YOU1 look for work?
1 Yes (Go to LBF_END)
2 No
DK , RF

LBF_D72A

DV_REMWK2 = DV_REMWK – LBF_Q71A

LBF_D72B

(not applicable)

LBF_Q72

That leaves ^DV_REMWK2 week[s] during which ^YOU1 ^WERE neither working nor looking for work. Is that correct?
1 Yes
2 No
DK , RF

LBF_E72

You have indicated that ^YOU1 worked for ^LBF_Q61 week[s] and that ^YOU1 ^WERE looking for work for ^LBF_Q71A week[s], leaving ^DV_REMWK2 week[s] during which ^YOU1 ^WERE neither working nor looking for work. The total number of weeks must add to 52. Please return and correct.

Note:

Trigger hard edit if LBF_Q72 = 2. Edit should return to LBF_Q61.

LBF_C73

If (LBF_Q01 = 1or LBF_Q02 = 1 or LBF_Q11 = 1), go to LBF_Q73.
Otherwise, go to LBF_END.

LBF_Q73

What is the main reason that ^YOU1 ^WERE not looking for work?
INTERVIEWER : If more than one reason, choose the one that explains the most number of weeks.
01 Own illness or disability (Go to LBF_Q74)
02 Caring for – own children
03 Caring for – elder relatives
04 Pregnancy (females only)
05 Other personal or family responsibilities
06 Vacation
07 Labour dispute (strike or lockout)
08 Temporary layoff due to business conditions
09 Seasonal layoff
10 Casual job, no work available
11 Work schedule (e.g., shift work)
12 School or educational leave
13 Retired
14 Believes no work available (in area or suited to skills)
15 Other – Specify (Go to LBF_S73)
DK , RF
Go to LBF_END

LBF_E73

A response of "Pregnancy" is invalid for a male respondent. Please return and correct.

Note:

Trigger hard edit if SEX_Q01 = 1 and LBF_Q73 = 4.

LBF_S73

INTERVIEWER : Specify.
(80 spaces)
DK , RF
Go to LBF_END

LBF_Q74

Was that due to ^YOUR1 physical health, to ^YOUR1 emotional or mental health, to ^YOUR1 use of alcohol or drugs, or to another reason?
1 Physical health
2 Emotional or mental health (including stress)
3 Use of alcohol or drugs
4 Another reason
DK , RF

LBF_END

Reasons for retirement (RET)

RET_BEG

Content block
External variables required:
PROXMODE: proxy identifier from the GR block
SEX_Q01: sex of specific respondent (1 = male, 2 = female) from SEX block
FNAME: first name of respondent from household block
CURRAGE: current age of respondent from AN2 block
DORET: do block flag from the sample file
LBF_Q01: Labour force participant from LBF block
LBF_Q02: Labour force participant from LBF block
LBF_Q03: Labour force participant from LBF block
PE_Q01: first name of specific respondent from USU block
PE_Q02: last name of specific respondent from USU block
Screen display:
Display on header bar PE_Q01 and PE_Q02 separated by a space

RET_C01A

If DORET = 1, go to RET_C01B.
Otherwise, go to RET_END.

RET_C01B

If CURRAGE < 86, go to RET_Q01.
Otherwise, go to RET_END.

RET_D01

(not applicable)

RET_Q01

At this time, ^DOVERB ^YOU2 consider ^YOURSELF to be completely retired, partly retired or not retired?
1 Completely retired
2 Partly retired
3 Not retired
DK , RF (Go to RET_END)

RET_E01

A response inconsistent with a response to a previous question has been entered.
Please confirm.

Note:

Trigger soft edit if (LBF_Q01 = 1 or LBF_Q02 = 1) and RET_Q01 = 1.

RET_C01C

If LBF_Q03 = 2 (never worked), go to RET_END.
Otherwise, go to RET_C01D.

RET_C01D

If RET_Q01 = 1, go to RET_Q03.
Otherwise, go to RET_Q02.

RET_Q02

^HAVE_C ^YOU1 ever retired from a job?
1 Yes
2 No
DK , RF

RET_C02A

If RET_Q01 = 2 (partly retired) and (RET_Q02 = 2, DK , RF ) (never retired from a job), go to RET_Q06A.
Otherwise, go to RET_C02B.

RET_C02B

If RET_Q01 = 3 (not retired) and (RET_Q02 = 2, DK , RF ) (never retired from a job), go to RET_END.
Otherwise, go to RET_Q03.

RET_Q03

After retirement, some people return to work and later retire again. ^HAVE_C ^YOU1 retired more than one time?
1 Yes
2 No
DK , RF

RET_C04

If RET_Q03 = 1 (retired more than once), go to RET_R04B.
Otherwise, go to RET_R04A.

RET_R04A

The following questions ask about ^YOUR1 retirement experience.
INTERVIEWER : Press <Enter> to continue.
Go to RET_D04

RET_R04B

The following questions ask about ^YOUR1 retirement experience. Please answer the following questions in relation to ^YOUR1 first retirement.
INTERVIEWER : Press <Enter> to continue.

RET_D04

If RET_Q03 = 1 (retired more than once), DT_RETIRED = "first retired".
Otherwise, DT_RETIRED = "retired".

RET_Q04A

Can you remember exactly how old ^YOU2 ^WERE when ^YOU1 ^DT_RETIRED?
1 Yes
2 No (Go to RET_Q04C)
DK (Go to RET_Q04C)
RF (Go to RET_D05)

RET_Q04B

How old ^WERE ^YOU1 when ^YOU1 ^DT_RETIRED?
Age in years
( MIN : 15) ( MAX : CURRAGE)
DK , RF

RET_E04BA

An unusual value has been entered. Please confirm.

Note:

Trigger soft edit if (RET_Q04B < 45).

RET_E04BB

An impossible value has been entered. Please return and correct.

Note:

Trigger hard edit if RET_Q04B > CURRAGE.

RET_C04B

If RET_Q04B = DK , go to RET_Q04C.
Otherwise, go to RET_D05.

RET_Q04C

About how old ^WERE ^YOU1 when ^YOU1 ^DT_RETIRED?
( MIN : 15) ( MAX : CURRAGE)
DK , RF

RET_E04CA

An unusual value has been entered. Please confirm.

Note:

Trigger soft edit if (RET_Q04C < 45).

RET_E04CB

An impossible value has been entered. Please return and correct.

Note:

Trigger hard edit if RET_Q04C > CURRAGE.

RET_D05

If RET_Q03 = 1 (Yes), DT_RETIRE = "the first time".
Otherwise, DT_RETIRE = "null".

RET_Q05A

(Please refer to page 9 of the booklet.)
There are many reasons why people retire. Which of the following reasons contributed to ^YOUR1 decision to retire ^DT_RETIRE?
INTERVIEWER : Read categories to respondent. Mark all that apply.
01 ^YOU2_C had completed the required years of service to qualify for a pension
02 Retirement was financially possible
03 Health/disability/stress reasons
04 Employer offered special incentives to retirement
05 Organizational restructuring or job eliminated
06 Providing care to a family member or friend
07 Employer had a mandatory retirement policy
08 Wished to pursue hobbies or other activities of personal interest
09 Wanted to stop work
10 An agreement with ^YOUR1 spouse or partner
11 Other – Specify (Go to RET_S05A)
DK , RF
Go to RET_C05

RET_S05A

INTERVIEWER : Specify.
(80 spaces)
DK , RF

RET_C05

If RET_Q05A = 3 (health reasons), go to RET_Q05B.
Otherwise, go to RET_C06A.

RET_Q05B

You mentioned that ^YOU2 took ^YOUR1 retirement because of ^YOUR1 health or stress or disability. Was this due to ^YOUR1 physical health, emotional or mental health, use of alcohol or drugs, or to another reason?
1 Physical health
2 Emotional or mental health (including stress)
3 Use of alcohol or drugs
4 Another reason
DK , RF

RET_C06A

If RET_Q01 = 1 (completely retired) or RET_Q02 = 1 (has ever retired), go to RET_D08.

RET_Q06A

Can you remember exactly how old ^YOU1 ^WERE when ^YOU1 partly retired?
1 Yes
2 No (Go to RET_Q06C)
DK (Go to RET_Q06C)
RF (Go to RET_C09)

RET_Q06B

How old ^WERE ^YOU1 when ^YOU1 partly retired?
INTERVIEWER : Enter age of respondent when partly retired.
Age in years
( MIN : 15) ( MAX : CURRAGE)
DK , RF

RET_E06BA

An unusual value has been entered. Please confirm.

Note:

Trigger soft edit if (RET_Q06B < 45).

RET_E06BB

An impossible value has been entered. Please return and correct.

Note:

Trigger hard edit if RET_Q06B > CURRAGE.

RET_C06C

If RET_Q06B = DK , go to RET_Q06C.
Otherwise, go to RET_C09.

RET_Q06C

About how old ^WERE ^YOU1 when ^YOU1 partly retired?
INTERVIEWER : Enter age of respondent when partly retired.
Age in years
( MIN : 15) ( MAX : CURRAGE)
DK , RF
Go to RET_C09

RET_E06CA

An unusual value has been entered. Please confirm.

Note:

Trigger soft edit if (RET_Q06C < 45).

RET_E06CB

An impossible value has been entered. Please return and correct.

Note:

Trigger hard edit if RET_Q06C > CURRAGE.

RET_D08

If RET_Q03 = 1 (Yes), DT_RETIREMENT = "first retirement".
Otherwise, DT_RETIREMENT = "retirement".

RET_C08

If RET_Q05A = 3 (retired because of health) or 7 (employer had a mandatory retirement policy), go to RET_C09.
Otherwise, go to RET_Q08.

RET_Q08

Would you say ^YOUR1 ^DT_RETIREMENT was voluntary, that is, ^YOU1 retired when ^YOU1 wanted to?
1 Yes
2 No
DK , RF

RET_C09

If PROXMODE = 1, go to RET_C10A.
Otherwise, go to RET_Q09.

RET_Q09

(Please refer to page 10 of the booklet.)
Assume that your ability to work for pay at your lifetime best has a value of 10 points. How many points would you give your current ability to work for pay? 0 means "completely unable to work" while 10 means "fully able to work".
00 Completely unable to work
01
02
03
04
05
06
07
08
09
10 Fully able to work
DK , RF

RET_C10A

If RET_Q03 = 1 (retired more than once) or (RET_Q01 = 3 and RET_Q02 = 1), go to RET_Q12.
Otherwise, go to RET_C10B.

RET_C10B

If RET_Q01 = 2 (partly retired) and (RET_Q02 = 2, DK , RF ) (never retired from a job), go to RET_END.

RET_Q10

After ^YOUR1 retirement, did ^YOU1 ever go back to work at any job or employment?
1 Yes (Go to RET_Q12)
2 No
DK , RF (Go to RET_END)

RET_E10

Respondent answered that he/she is currently partially retired and has retired previously. Please confirm.

Note:

Trigger soft edit if RET_Q01 = 2 and RET_Q02 = 1 and RET_Q10 = 2.

RET_Q11

Did ^YOU1 look for paid work at any time after ^YOUR1 ^DT_RETIREMENT?
1 Yes
2 No
DK , RF
Go to RET_END

RET_D12

(not applicable)

RET_Q12

(Please refer to page 11 of the booklet.)
Which of the following reasons contributed to ^YOUR1 decision to go back to work at any job or employment after ^YOU1 ^DT_RETIRED?
INTERVIEWER : Read categories to respondent. Mark all that apply.
01 Financial considerations
02 Caregiving duties were no longer required
03 Improvement in ^YOUR1 health
04 Liked working/being active
05 Interesting work opportunity
06 Preferred gradual retirement
07 Wanted to make a contribution
08 Wanted a challenge
09 Did not like retirement or not ready to retire
10 Other – Specify (Go to RET_S12)
DK , RF
Go to RET_END

RET_S12

INTERVIEWER : Specify.
(80 spaces)
DK , RF

RET_END

Retirement planning (RPL)

RPL_BEG

Content block
External variables required:
SEX_Q01: sex of specific respondent (1 = male, 2 = female) from Sex block
PROXMODE: proxy identifier from the GR block
FNAME: first name of respondent from household block
CURRAGE: current age of respondent from AN2 block
DORPL: do block flag from the sample file
PE_Q01: first name of specific respondent from USU block
PE_Q02: last name of specific respondent from USU block
RET_Q01: self–identified retiement status from retirement module RET block
RET_Q02: retired previously from retirement module RET block
LBF_Q03: has worked before from LBF block
LONG: longitudinal indicator from sample file
Screen display:
Display on header bar PE_Q01 and PE_Q02 separated by a space.

RPL_C01A

If DORPL = 1, go to RPL_C01B.
Otherwise, go to RPL_END.

RPL_C01B

If (CURRAGE < 86) and (RET_Q01 = 2, 3) and (LBF_Q03 <> 2), go to RPL_R01.
Otherwise, go to RPL_END.

RPL_R01

The next few questions ask about preparations for retirement. Some of these questions may not apply to ^YOU2 but we need to ask the same questions of everyone.
INTERVIEWER : Press <Enter> to continue.

RPL_C01C

If RET_Q02 = 2 (never retired from a job), go to RPL_Q01A.
Otherwise, go to RPL_D02.

RPL_Q01A

At what age ^DOVERB ^YOU1 plan to retire?
INTERVIEWER : Enter the age the respondent would like to fully retire, minimum is ^CURRAGE, maximum is 130. If the respondent doesn't intend to retire, please enter <995>.
Age in years
( MIN : ^CURRAGE) ( MAX : 995)
DK , RF

RPL_E01A

An impossible value has been entered. Please return and correct.

Note:

Trigger hard edit if ((RPL_Q01A < CURRAGE or RPL_Q01A >130) and (RPL_Q01A <> 995, DK , RF ))

RPL_C01D

If RPL_Q01A = DK or 995, go to RPL_Q01B.
Otherwise, go to RPL_C01E.

RPL_C01E

If RPL_Q01A = RF , go to RPL_END.
Otherwise, go to RPL_D02.

RPL_Q01B

Is that because:
INTERVIEWER : Read categories to respondent.
1 …^YOU1 ^HAVE not thought about or planned for retirement?
2 …^YOU1 plan^S to continue working for as long as ^YOU1 ARE able to?
3 …^YOU1 can’t afford to retire?
4 Other – Specify (Go to RPL_S01B)
DK , RF
Go to RPL_D02

RPL_S01B

INTERVIEWER : Specify.
(80 spaces)
DK , RF

RPL_D02

(not applicable)

RPL_Q02

(Please refer to page 12 of the booklet.)
^HAVE_C ^YOU1 done any of the following in preparation for ^YOUR1 retirement?
INTERVIEWER : Read categories to the respondent.
Mark all that apply.
01 Decreased ^YOUR1 number of work hours
02 Increased ^YOUR1 number of work hours
03 Changed jobs
04 Increased physical activities
05 Increased other leisure activities and hobbies
06 Enrolled in an educational or training program
07 Gathered retirement information
08 Contributed to an RRSP
09 Built up savings or made other investments
10 Paid–off mortgage or debts
11 Downsized living arrangements
12 None
13 Other – Specify (Go to RPL_S02)
DK , RF
Go to RPL_C03A

RPL_S02

INTERVIEWER : Specify.
(80 spaces)
DK , RF

RPL_E02

You cannot select "none" and another category. Please return and correct.

Note:

Trigger hard edit if RPL_Q02 = 12 and any other response selected in RPL_Q02.

RPL_C03A

If PROXYMODE = 1, go to RPL_Q04.
Otherwise, go to RPL_C03B.

RPL_C03B

If RET_Q01 = 3 (not retired) and RET_Q02 = 2 (never retired from a job), go to
RPL_Q03.

RPL_Q03

(Please refer to page 10 of the booklet.)
Assume that your ability to work for pay at your lifetime best has a value of 10 points. How many points would you give your current ability to work for pay? 0 means "completely unable to work" while 10 means "fully able to work".
00 Completely unable to work
01
02
03
04
05
06
07
08
09
10 Fully able to work
DK , RF

RPL_Q04

^HAVE_C ^YOU1 ever contributed to an employer pension plan, other than the Canada pension plan or Quebec pension plan?
1 Yes
2 No
DK , RF

RPL_C07

If RET_Q02 = 2 (never has retired from a job), go to RPL_D08.
Otherwise, go to RPL_END.

RPL_D08

(not applicable)

RPL_Q08

When ^YOU2 retire^S, how adequate do you think ^YOUR1 household income and investments will be to maintain ^YOUR1 standard of living? Will they be:
INTERVIEWER : Read categories to respondent.
1 …more than adequate?
2 …adequate?
3 …barely adequate?
4 …inadequate?
5 …very inadequate?
DK , RF

RPL_END

Home owner (OWN)

OWN_BEG

Content block
External variables required:
PROXMODE: proxy identifier, from the GR block.
FNAME: first name of respondent from household block.
DOOWN: do block flag, from the sample file.
PE_Q01: first name of specific respondent from USU block
PE_Q02: last name of specific respondent from USU block

OWN_C01

If DOOWN = 1, go to OWN_R01.
Otherwise, go to OWN_END.

OWN_D01

not applicable

OWN_R01

The next questions concern ^YOUR2 dwelling.
INTERVIEWER : Press <Enter> to continue.

OWN_Q01

^DOVERB_C ^YOU1 (or ^YOUR1 spouse/partner) own or rent this dwelling?
1 Own
2 Rent (Go to OWN_END)
3 Other (Go to OWN_END)
DK , RF (Go to OWN_END)

OWN_Q02

Is this with a mortgage or is ^YOUR1 mortgage paid off completely?
INTERVIEWER : If the dwelling never had a mortgage or was received as a gift or an inheritance, select "2 – Paid off completely".
1 With mortgage
2 Paid off completely (Go to OWN_Q04A)
DK , RF (Go to OWN_Q04A)

OWN_Q03A

What is the amount remaining on ^YOUR1 mortgage?
INTERVIEWER : Record best estimate.
( MIN : 1) ( MAX : 9999995: warning after 1500000)
DK , RF (Go to OWN_Q03B)
Go to OWN_Q04A

OWN_Q03B

What is the approximate amount remaining on ^YOUR1 mortgage? Is it:
INTERVIEWER: Read categories to respondent until the respondent selects the category
1 Less than $25,000?
2 $25,000 or more but less than $75,000?
3 $75,000 or more but less than $150,000?
4 $150,000 or more but less than $300,000?
5 $300,000 or more but less than $500,000?
6 $500,000 or more?
DK , RF

OWN_Q04A

If ^YOU1 were selling this property now, for how much would ^YOU1 expect to sell it?
INTERVIEWER : Record best estimate.
( MIN : 1000) ( MAX : 9999995: warning after 1500000)
DK , RF (Go to OWN_Q04B)
Go to OWN_END

OWN_Q04B

(If ^YOU1 were selling this property now,) for approximately how much would ^YOU1 expect to sell it. Would it be:
INTERVIEWER : Read categories to respondent until the respondent selects the category
1 Less than $25,000?
2 $25,000 or more but less than $75,000?
3 $75,000 or more but less than $150,000?
4 $150,000 or more but less than $300,000?
5 $300,000 or more but less than $500,000?
6 $500,000 or more?
DK , RF

OWN_END

Income (INC)

INC_BEG

Content block
External variables required:
PROXMODE: proxy identifier from the GR block
FNAME: first name of respondent from household block
DOINC: do block flag from the sample file
HHLDSZ: household size from Demographic component
LBF_Q01: Question 1 from the Labour Force component
LBF_Q02: Question 2 from the Labour Force component
LBF_Q21: Question 21 from the Labour Force component
PE_Q01: first name of specific respondent from USU block
PE_Q02: last name of specific respondent from USU block
CURRAGE: current age of respondent from AN2 block
Screen display:
Display on header bar PE_Q01 and PE_Q02 separated by a space

INC_C01

If DOINC = 1, go to INC_R01.
Otherwise, go to INC_END.

INC_R01

(Please refer to page 13 of the booklet.)
Although many health expenses are covered by health insurance, there is still a relationship between health and income. Please be assured that, like all other information you have provided, these answers will be kept strictly confidential.
INTERVIEWER : Press <Enter> to continue.

INC_D01A

(not applicable)

INC_D01B

(not applicable)

INC_Q01

Thinking about the total income for all household members, from which of the following sources did ^YOUR2 household receive any income in the past 12 months?
INTERVIEWER : Read categories to respondent.
Mark all that apply.
01 Wages and salaries
02 Income from self–employment
03 Dividends and interest (e.g., on bonds, savings)
04 Employment insurance
05 Worker's compensation
06 Benefits from Canada or Quebec Pension Plan
07 Job related retirement pensions, superannuation and annuities
08 RRSP/RRIF (Registered Retirement Savings Plan/Registered Retirement Income Fund)
09 Old Age Security and Guaranteed Income Supplement
10 Provincial or municipal social assistance or welfare
11 Child Tax Benefit
12 Child support
13 Alimony
14 Other (e.g., rental income, veterans’ pensions)
15 None
DK , RF (Go to INC_C07)

INC_E01A

You cannot select "None" and another category. Please return and correct.

Note:

Trigger hard edit if INC_Q01 = 15 and any other response selected in INC_Q01.

INC_E01B

Inconsistent answers have been entered. Please confirm.

Note:

Trigger soft edit if (INC_Q01 <> 1 or 2) and ( (LBF_Q01 = 1) or (LBF_Q02 = 1) or (LBF_Q021 = 1) ).

INC_C02

If more than one source of income is indicated in INC_Q01, go to INC_Q02.
Otherwise, go to INC_Q03A.

INC_Q02

What was the main source of household income?
01 Wages and salaries
02 Income from self–employment
03 Dividends and interest (e.g., on bonds, savings)
04 Employment insurance
05 Worker's compensation
06 Benefits from Canada or Quebec Pension Plan
07 Job related retirement pensions, superannuation and annuities
08 RRSP/RRIF (Registered Retirement Savings Plan/Registered Retirement Income Fund)
09 Old Age Security and Guaranteed Income Supplement
10 Provincial or municipal social assistance or welfare
11 Child Tax Benefit
12 Child support
13 Alimony
14 Other (e.g., rental income, veterans’ pensions)
15 None
DK , RF (Go to INC_C07)

Note:

At the time of the data processing, if the respondent reported only one source of income in INC_Q01, the variable INC_Q02 will be given its value.

INC_E02

A blank answer item has been selected. Please return and correct.

Note:

Trigger hard edit if the response in INC_Q02 was not selected in INC_Q01.

INC_Q03A

What is your best estimate of the total household income received by all household members, from all sources, before taxes and deductions, in the past 12 months?
INTERVIEWER : Income can come from various sources such as from work, investments, pensions or government. Examples include Employment Insurance, Social Assistance, Child Tax Benefit and other income such as child support, alimony and rental income.
Income
( MIN : 0) ( MAX : 500,000)
DK , RF (Go to INC_D03B)

Note:

At the time of the data processing, responses reported in INC_Q03A will also be recoded into the cascade categories of INC_Q03B to INC_Q03H.

INC_E03A

An unusual value has been entered. Please confirm.

Note:

Trigger soft edit if INC_Q03A > 150,000.

INC_C03A

If INC_Q03A = 0, go to INC_C07.
Otherwise, go to INC_C03B.

INC_C03B

If INC_Q03A > 0 and INC_Q03A <= 500,000, go to INC_C04.
Otherwise, go to INC_D03B.

INC_D03B

(not applicable)

INC_Q03B

What is your best estimate of the total household income received by all household members, from all sources, before taxes and deductions, in the past 12 months? Was it:
INTERVIEWER : Read categories to respondent.
1 … less than $50,000 (include income loss)?
2 … $50,000 and more? (Go to INC_Q03H)
DK , RF (Go to INC_C07)

INC_Q03C

Please stop me when I have read the category which applies to ^YOUR1 household.
INTERVIEWER : Read categories to respondent.
1 Less than $5,000
2 $5,000 or more but less than $10,000
3 $10,000 or more but less than $15,000
4 $15,000 or more but less than $20,000
5 $20,000 or more but less than $30,000
6 $30,000 or more but less than $40,000
7 $40,000 or more but less than $50,000
DK , RF
Go to INC_C04

INC_Q03H

Please stop me when I have read the category which applies to ^YOUR1 household.
INTERVIEWER : Read categories to respondent.
1 $50,000 or more but less than $60,000
2 $60,000 or more but less than $70,000
3 $70,000 or more but less than $80,000
4 $80,000 or more but less than $90,000
5 $90,000 or more but less than $100,000
6 $100,000 or more but less than $150,000
7 $150,000 and over
DK , RF

INC_C04

If HHLDSZ > 1, go to INC_D04.
Otherwise, go to INC_C07.

INC_D04

(not applicable)

INC_Q04

Thinking about ^YOUR2 total personal income, from which of the following sources did ^YOU1 receive any income in the past 12 months?
INTERVIEWER : Read categories to respondent.
Mark all that apply.
01 Wages and salaries
02 Income from self–employment
03 Dividends and interest (e.g., on bonds, savings)
04 Employment insurance
05 Worker's compensation
06 Benefits from Canada or Quebec Pension Plan
07 Job related retirement pensions, superannuation and annuities
08 RRSP/RRIF (Registered Retirement Savings Plan/Registered Retirement Income Fund)
09 Old Age Security and Guaranteed Income Supplement
10 Provincial or municipal social assistance or welfare
11 Child Tax Benefit
12 Child support
13 Alimony
14 Other (e.g., rental income, veterans’ pensions)
15 None
DK , RF (Go to INC_C07)

INC_E04A

A selected source of personal income is not selected as one of the sources of income for all household members. Please return and correct.

Note:

Trigger hard edit if any response other than 15 is selected in INC_Q04 and is not selected in INC_Q01.

INC_E04B

You cannot select "None" and another category. Please return and correct.

Note:

Trigger hard edit if INC_Q04 = 15 (None) and any other response selected in

INC_C05

If more than one source of income is indicated in INC_Q04, go to INC_Q05.
Otherwise, go to INC_D06A.

INC_Q05

What was the main source of ^YOUR1 personal income?
01 Wages and salaries
02 Income from self–employment
03 Dividends and interest (e.g., on bonds, savings)
04 Employment insurance
05 Worker's compensation
06 Benefits from Canada or Quebec Pension Plan
07 Job related retirement pensions, superannuation and annuities
08 RRSP/RRIF (Registered Retirement Savings Plan/Registered Retirement Income Fund)
09 Old Age Security and Guaranteed Income Supplement
10 Provincial or municipal social assistance or welfare
11 Child Tax Benefit
12 Child support
13 Alimony
14 Other (e.g., rental income, veterans’ pensions)
15 None
DK , RF (Go to INC_C07)

Note:

At the time of the data processing, if the respondent reported only one source of income in INC_Q04, the variable INC_Q05 will be given its value.

INC_E05

A blank answer item has been selected. Please return and correct.

Note:

Trigger hard edit if the response in INC_Q05 was not selected in INC_Q04.

INC_D06A

(not applicable)

INC_Q06A

What is your best estimate of ^YOUR1 total personal income from all sources, before taxes and deductions, in the past 12 months?
Income
( MIN : 0) ( MAX : 500,000)
DK , RF (Go to INC_Q06B)

Note:

At the time of the data processing, responses reported in INC_Q06A will also be coded into the cascade categories of INC_Q06B to INC_Q06H.

INC_E06A

An unusual value has been entered. Please confirm.

Note:

Trigger soft edit if INC_Q06A > $150,000.

INC_C06A

If INC_Q06A = 0, go to INC_C07.
Otherwise, go to INC_C06B.

INC_C06B

If INC_Q06A > 0 and INC_Q06A <= 500,000, go to INC_C07.
Otherwise, go to INC_Q06B.

INC_Q06B

What is your best estimate of ^YOUR1 total personal income from all sources, before taxes and deductions, in the past 12 months? Was it:
INTERVIEWER : Read categories to respondent.
1 … less than $30,000?
2 … $30,000 or more? (Go to INC_Q06H)
DK , RF (Go to INC_C07)

INC_Q06C

Please stop me when I have read the category which applies to ^YOU2.
INTERVIEWER : Read categories to respondent.
1 Less than $5,000
2 $5,000 or more but less than $10,000
3 $10,000 or more but less than $15,000
4 $15,000 or more but less than $20,000
5 $20,000 or more but less than $25,000
6 $25,000 or more but less than $30,000
DK , RF
Go to INC_C07

INC_Q06H

Please stop me when I have read the category which applies to ^YOU2.
INTERVIEWER : Read categories to respondent.
1 $30,000 or more but less than $40,000
2 $40,000 or more but less than $50,000
3 $50,000 or more but less than $60,000
4 $60,000 or more but less than $70,000
5 $70,000 or more but less than $80,000
6 $80,000 or more but less than $90,000
7 $90,000 or more but less than $100,000
8 $100,000 and over
DK , RF

INC_C07

If (HHLDSZ > 1 (not living alone) and INC_Q04 = 6 (received benefits from CPP/QPP)) or (if HHLDSZ =1 (living alone) and INC_Q01 = 6 (received benefits from CPP/QPP)), go to INC_Q07.
Otherwise, go to INC_R12.

INC_Q07

You mentioned that ^YOU2 received benefits from Canada or Quebec Pension Plan. What is the monthly amount of these benefits?
INTERVIEWER : Enter the best estimate. Include all benefits (retirement pension, survivor benefits, disability benefits or combined benefits). Exclude the death benefit that is received only once.
Monthly benefit
( MIN : 1) ( MAX : 1,500)
DK , RF (Go to INC_Q08, RF go to INC_R12)

INC_E07

An unusual value has been entered. Please confirm.

Note:

Trigger soft edit if INC_Q07 > 1,300.

INC_Q08

Which type of benefits did ^YOU1 receive?
INTERVIEWER : Read categories to respondent. Mark all that apply.
1 Retirement pension
2 Survivor benefits
3 Disability benefits
DK , RF (Go to INC_R12)

INC_E08A

An impossible value has been entered. minimum age to receive retirement pension is 60. Please return and correct.

Note:

Trigger hard edit if INC_Q08 = 1 and CURRAGE < 60.

INC_E08B

An unusual value has been entered. Please confirm.

Note:

Trigger soft edit if (INC_Q08 = 1 (retirement pension) and INC_Q08 = 3 (disability benefits)).

INC_C09

If INC_Q08 = 1 (received retirement pension), go to INC_Q09.
Otherwise, go to INC_C10.

INC_Q09

At what age did ^YOU1 start receiving a retirement pension from Canada or Quebec pension plan?
INTERVIEWER : Enter the age.
Age in years
( MIN : 60) ( MAX : 100)
DK , RF (Go to INC_R12)

INC_E09A

An impossible value has been entered. Please return and correct.

Note:

Trigger hard edit if INC_Q09 > CURRAGE.

INC_E09B

An unusual value has been entered. Please confirm.

Note:

Trigger soft edit if INC_Q09 > 75.

INC_C10

If INC_Q08 = 2 (received survivor benefits), go to INC_Q10.
Otherwise, go to INC_C11.

INC_Q10

At what age did ^YOU1 start receiving survivor benefits from Canada or Quebec pension plan?
INTERVIEWER : Enter the age. Exclude survivor benefits received as a child.
Age in years
( MIN : 18) ( MAX : 100)
DK , RF (Go to INC_R12)

INC_E10A

An unusual value has been entered. Please confirm.

Note:

Trigger soft edit if INC_Q10 < 20.

INC_E10B

An impossible value has been entered. Please return and correct.

Note:

Trigger hard edit if INC_Q10 > CURRAGE.

INC_C11

If INC_Q08 = 3 (received disability benefits), go to INC_Q11.
Otherwise, go to INC_R12.

INC_Q11

At what age did ^YOU1 start receiving disability benefits from Canada or Quebec pension plan?
INTERVIEWER : Enter the age. Exclude disability benefits received as a child.
Age in years
( MIN : 18) ( MAX : 100)
DK , RF

INC_E11A

An unusual value has been entered. Please confirm.

Note:

Trigger soft edit if INC_Q11 < 20.

INC_E11B

An impossible value has been entered. Please return and correct.

INC_R12

Now some questions about ^YOUR1 overall financial situation.

INC_Q12

With ^YOUR1 current household income, ^DOVERB ^YOU1 have any difficulty meeting basic expenses such as food, shelter and clothing?
1 Yes
2 No
DK , RF

INC_Q13

Approximately, how much in savings and investments ^DOVERB ^YOU2 (and ^YOUR1 spouse/partner) have in total? Please exclude the value of ^YOUR1 principal residence and any employer pension plans.
INTERVIEWER : Include deposits in financial institutions, mutual funds, investment funds, stocks, bonds, RRSPs, other retirement saving accounts, other financial assets, other real estate, vehicles, other non–financial assets and equity in business.
Read categories to respondent until the respondent selects the
1 Less than $25,000
2 $25,000 or more but less than $75,000
3 $75,000 or more but less than $150,000
4 $150,000 or more but less than $300,000
5 $300,000 or more but less than $500,000
6 $500,000 or more
DK , RF

INC_END

Socio–demographic characteristics (SDC)

SDC_BEG

Content block
External variables required:
PROXMODE: proxy identifier, from the GR block
FNAME: first name of respondent from household block
DOSDC: do block flag from the sample file
DVDATE: date of birth from DATE
REFDATE: current date from operating system
PE_Q01: first name of specific respondent from USU block
PE_Q02: last name of specific respondent from USU block
Screen display:
Display on header bar PE_Q01 and PE_Q02 separated by a space

SDC_C01

If DOSDC = 1, go to SDC_R1.
Otherwise, go to SDC_END.

SDC_R1

Now some general background questions which will help us compare the health of people in Canada.
INTERVIEWER : Press <Enter> to continue.

SDC_Q1

In what country ^WERE ^YOU2 born?
01 Canada (Go to SDC_Q4)
02 China
03 France
04 Germany
05 Greece
06 Guyana
07 Hong Kong
08 Hungary
09 India
10 Italy
11 Jamaica
12 Netherlands / Holland
13 Philippines
14 Poland
15 Portugal
16 United Kingdom
17 United States
18 Viet Nam
19 Sri Lanka
20 Other – Specify (Go to SDC_S1)
DK , RF (Go to SDC_D4)
Go to SDC_Q2

SDC_S1

INTERVIEWER : Specify.
(80 spaces)
DK , RF

SDC_Q2

^WERE_C ^YOU1 born a Canadian citizen?
1 Yes (Go to SDC_D4)
2 No
DK , RF (Go to SDC_D4)

SDC_Q3

In what year did ^YOU1 first come to Canada to live?
INTERVIEWER : minimum is ^DVDATE; maximum is ^REFDATE.
Year
DK , RF

SDC_E3

Year must be between ^DVDATE and ^REFDATE.

Note:

Trigger hard edit if SDC_Q3 < DVDATE or SDC_Q3 > REFDATE.

SDC_D4

(not applicable)

SDC_Q4

To which ethnic or cultural groups did ^YOUR2 ancestors belong? (For example: French, Scottish, Chinese, East Indian)
INTERVIEWER : Mark all that apply.
If "Canadian" is the only response, probe. If the respondent hesitates, do not suggest Canadian.
If the respondent answers "Eskimo", enter "20".
01 Canadian
02 French
03 English
04 German
05 Scottish
06 Irish
07 Italian
08 Ukrainian
09 Dutch (Netherlands)
10 Chinese
11 Jewish
12 Polish
13 Portuguese
14 South Asian (e.g. East Indian, Pakistani, Sri Lankan)
15 Norwegian
16 Welsh
17 Swedish
18 North American Indian
19 Métis
20 Inuit
21 Other – Specify (Go to SDC_S4)
DK , RF
Go to SDC_Q4_1

SDC_S4

INTERVIEWER : Specify.
(80 spaces)
DK , RF

SDC_Q4_1

^ARE_C ^YOU1 an Aboriginal person, that is, North American Indian, Métis or Inuit?
1 Yes
2 No (Go to SDC_Q4_3)
DK , RF (Go to SDC_Q5)

SDC_Q4_2

^ARE_C ^YOU1:
INTERVIEWER : Read categories to respondent.
Mark all that apply.
If respondent answers "Eskimo", enter "3".
1 …North American Indian?
2 …Métis?
3 …Inuit?
DK , RF
Go to SDC_Q5

SDC_Q4_3

People living in Canada come from many different cultural and racial backgrounds. ^ARE_C ^YOU1:
INTERVIEWER : Read categories to respondent.
Mark all that apply.
01 … White?
02 … Chinese?
03 … South Asian (e.g., East Indian, Pakistani, Sri Lankan)?
04 … Black?
05 … Filipino?
06 … Latin American?
07 … Southeast Asian (e.g., Cambodian, Indonesian, Laotian, Vietnamese)?
08 … Arab?
09 … West Asian (e.g., Afghan, Iranian)?
10 … Japanese?
11 … Korean?
12 Other – Specify (Go to SDC_S4_3)
DK , RF
Go to SDC_Q5

SDC_S4_3

INTERVIEWER : Specify.
(80 spaces)
DK , RF

SDC_Q5

In what languages can ^YOU1 conduct a conversation?
INTERVIEWER : Mark all that apply.
01 English
02 French
03 Arabic
04 Chinese
05 Cree
06 German
07 Greek
08 Hungarian
09 Italian
10 Korean
11 Persian (Farsi)
12 Polish
13 Portuguese
14 Punjabi
15 Spanish
16 Tagalog (Filipino)
17 Ukrainian
18 Vietnamese
19 Dutch
20 Hindi
21 Russian
22 Tamil
23 Other – Specify (Go to SDC_S5)
DK , RF
Go to SDC_Q5A

SDC_S5

INTERVIEWER : Specify.
(80 spaces)
DK , RF

SDC_Q5A

What language ^DOVERB ^YOU1 speak most often at home?
INTERVIEWER : Mark all that apply.
01 English
02 French
03 Arabic
04 Chinese
05 Cree
06 German
07 Greek
08 Hungarian
09 Italian
10 Korean
11 Persian (Farsi)
12 Polish
13 Portuguese
14 Punjabi
15 Spanish
16 Tagalog (Filipino)
17 Ukrainian
18 Vietnamese
19 Dutch
20 Hindi
21 Russian
22 Tamil
23 Other – Specify (Go to SDC_S5A)
DK , RF
Go to SDC_D6

SDC_S5A

INTERVIEWER : Specify.
(80 spaces)
DK , RF

SDC_D6

(not applicable)

SDC_Q6

What is the language that ^YOU2 first learned at home in childhood and can still understand?
INTERVIEWER : Mark all that apply.
If person can no longer understand the first language learned, mark the second.
01 English
02 French
03 Arabic
04 Chinese
05 Cree
06 German
07 Greek
08 Hungarian
09 Italian
10 Korean
11 Persian (Farsi)
12 Polish
13 Portuguese
14 Punjabi
15 Spanish
16 Tagalog (Filipino)
17 Ukrainian
18 Vietnamese
19 Dutch
20 Hindi
21 Russian
22 Tamil
23 Other – Specify (Go to SDC_S6)
DK , RF
Go to SDC_C7A

SDC_S6

INTERVIEWER : Specify.
(80 spaces)
DK , RF

SDC_C7A

If PROXMODE = 1, go to SDC_END.
Otherwise, go to SDC_R7A.

SDC_R7A

Now one additional background question which will help us compare the health of people in Canada.

SDC_Q7A

Do you consider yourself to be:
INTERVIEWER : Read categories to respondent.
1 …heterosexual? (sexual relations with people of the opposite sex)
2 …homosexual, that is lesbian or gay? (sexual relations with people of your own sex)
3 …bisexual? (sexual relations with people of both sexes)
DK , RF

SDC_END

Administration information (ADM)

ADM_BEG

Content block
External variables required:
PROXMODE: proxy identifier from the GR block
FNAME: first name of respondent from household block
PROV: listing address alphabetic province coding
DOADM: do block flag from the sample file
DOADF: do block flag from the sample file
DOCLS: do block flag from the sample file
SEX_Q01: sex of specific respondent (1=male, 2=female) from SEX block

ADM_C01

If DOADM = 1, go to ADM_D01A.
Otherwise, go to ADM_END.

ADM_D01A

If PROV = 24, ^QUEBECHNE = "Statistics Canada, your provincial ministry of health and the "Institut de la Statistique du Québec"".
Otherwise, ^QUEBECHNE = "Statistics Canada and your provincial ministry of

Note:

Data linkage

ADM_D01B

(not applicable)

ADM_R01

^QUEBECHNE would like your permission to link information collected during this interview. This includes linking your survey information to ^YOUR2 past and continuing use of health services such as visits to hospitals, clinics and doctors' offices.
INTERVIEWER : Press <Enter> to continue.

ADM_Q01

This linked information will be kept confidential and used only for statistical purposes. Do we have your permission?
1 Yes
2 No (Go to ADM_D04)
DK , RF (Go to ADM_D04)

ADM_D02A

If PROV = 59, PROVNAME = "British Columbia".
If PROV = 48, PROVNAME = "Alberta".
If PROV = 47, PROVNAME = "Saskatchewan".
If PROV = 46, PROVNAME = "Manitoba".
If PROV = 35, PROVNAME = "Ontario".
If PROV = 24, PROVNAME = "Quebec".
If PROV = 13, PROVNAME = "New Brunswick".
If PROV = 12, PROVNAME = "Nova Scotia".
If PROV = 11, PROVNAME = "Prince Edward Island".
If PROV = 10, PROVNAME = "Newfoundland and Labrador".

Note:

Health number

ADM_D02B

If PROV = (35, 48), DT_AN = "an".
Otherwise, DT_AN = "a".

ADM_Q02A

Having a provincial health number will assist us in linking to this other information. ^DOVERB_C ^YOU2 have ^DT_AN ^PROVNAME health number?
1 Yes (Go to ADM_DHNB)
2 No
DK , RF (Go to ADM_D04)

ADM_Q02B

For which province or territory is ^YOUR1 health number?
10 Newfoundland and Labrador
11 Prince Edward Island
12 Nova Scotia
13 New Brunswick
24 Quebec
35 Ontario
46 Manitoba
47 Saskatchewan
48 Alberta
59 British Columbia
60 Yukon
61 Northwest Territories
62 Nunavut
88 Do not have a Canadian health number (Go to ADM_D04)
DK , RF (Go to ADM_D04)

ADM_DHNA

If ADM_Q02B = 62, PROVHNE = "Nunavut".
If ADM_Q02B = 61, PROVHNE = "Northwest Territories".
If ADM_Q02B = 60, PROVHNE = "Yukon".
If ADM_Q02B = 59, PROVHNE = "British Columbia".
If ADM_Q02B = 48, PROVHNE = "Alberta".
If ADM_Q02B = 47, PROVHNE = "Saskatchewan".
If ADM_Q02B = 46, PROVHNE = "Manitoba".
If ADM_Q02B = 35, PROVHNE = "Ontario".
If ADM_Q02B = 24, PROVHNE = "Quebec".
If ADM_Q02B = 13, PROVHNE = "New Brunswick".
If ADM_Q02B = 12, PROVHNE = "Nova Scotia".
If ADM_Q02B = 11, PROVHNE = "Prince Edward Island".
If ADM_Q02B = 10, PROVHNE = "Newfoundland and Labrador".

ADM_DHNB

If ADM_Q02A = 1, PROVFROME = "PROVNAME".
Otherwise, PROVFROME = "PROVHNE".

ADM_QHN

What is ^YOUR1 health number?
INTERVIEWER : Enter a health number for ^PROVFROME. Do not insert blanks, hyphens or commas between the numbers.
(8–12 spaces)
DK , RF

ADM_D04

If PROV = 24, QUEBECPSE = "provincial and territorial ministries of health, the "Institut de la Statistique du Québec", Health Canada and the Public Health Agency of Canada".
Otherwise, QUEBECPSE = "provincial and territorial ministries of health, Health Canada and the Public Health Agency of Canada".

Note:

Data Sharing

ADM_R04

Statistics Canada would like your permission to share the information collected in this survey with ^QUEBECPSE.
Provincial and Territorial ministries of health may make this information available to local health authorities. Your name, address, telephone number and health number will not be provided to the local health authorities, Health Canada or the Public Health Agency of Canada.
INTERVIEWER : Press <Enter> to continue.

ADM_Q04

All information will be kept confidential and used only for statistical purposes.
Do you agree to share the information provided?
1 Yes
2 No
DK , RF

ADM_C05

If DOCLS = 1, go to ADM_B05.
Otherwise, go to ADM_C06.

ADM_B05

Call Consent to share block (CLS).

ADM_C06

If DOADF = 1, go to ADM_B06.
Otherwise, go to ADM_N09.

ADM_B06

Call Administration – Fictitious Name block (ADF).

Note:

Administration

ADM_N09

INTERVIEWER : Was this interview conducted on the telephone or in person?
1 On telephone
2 In person
3 Both
DK , RF

ADM_D10

(not applicable)

ADM_N10

INTERVIEWER : Was the respondent alone when you asked this health
1 Yes (Go to ADM_N12)
2 No
DK , RF (Go to ADM_N12)

ADM_N11

INTERVIEWER : Do you think that the answers of the respondent were affected by someone else being there?
1 Yes
2 No
DK , RF

ADM_N12

INTERVIEWER : Record language of interview.
01 English
02 French
03 Chinese
04 Italian
05 Punjabi
06 Spanish
07 Portuguese
08 Polish
09 German
10 Vietnamese
11 Arabic
12 Tagalog (Filipino)
13 Greek
14 Tamil
15 Cree
16 Afghan
17 Cantonese
18 Hindi
19 Mandarin
20 Persian
21 Russian
22 Ukrainian
23 Urdu
24 Inuktitut
90 Other – Specify (Go to ADM_S12)
DK , RF
Go to ADM_END

ADM_S12

INTERVIEWER : Specify.
(80 spaces)
DK , RF

ADM_END

Administration – fictitious name (ADF)

ADF_BEG

Content block
External variables required:
PROXMODE: proxy identifier from the GR block.
FNAME: first name of respondent from household block.

ADF_N05

INTERVIEWER : Is this a fictitious name for the respondent?
1 Yes
2 No (Go to ADF_END)
DK , RF (Go to ADF_END)

ADF_N06

INTERVIEWER : Remind respondent about the importance of getting correct names.
Do you want to make corrections to:
1 …first name only?
2 …last name only? (Go to ADF_N08)
3 …both names?
4 …no corrections? (Go to ADF_END)
DK , RF (Go to ADF_END)

ADF_N07

INTERVIEWER : Enter the first name only.
(25 spaces)
DK , RF

ADF_C08

If ADF_N06 = 3, go to ADF_N08.
Otherwise, go to ADF_END.

ADF_N08

INTERVIEWER : Enter the last name only.
(25 spaces)
DK , RF

ADF_END

Consent to share (CLS)

CLS_BEG

Content block
External variables required:
PE_Q01: first name of specific respondent from USU block
PE_Q02: last name of specific respondent from USU block
PROXMODE: proxy identifier from the GR block
FNAME: First name of the selected respondent
CURRAGE: current age of respondent from AN2 block
SEX_Q01: sex of specific respondent (1=male, 2=female) from SEX block
Screen display:
Display on header bar PE_Q01 and PE_Q02 separated by a space

CLS_C01

If CURRAGE < 86, go to CLS_N01A.
Otherwise, go to CLS_END.

CLS_N01A

INTERVIEWER : Enter the 6–digit respondent ID number from the Canadian Longitudinal Study on Aging (CLSA) consent form.
Respondent identifier
( MIN : 100000) ( MAX : 999999)
( DK , RF are not allowed)

CLS_N01B

INTERVIEWER : Please re–enter the 6–digit respondent ID number from the CLSA consent form.
Respondent identifier
( MIN : 100000) ( MAX : 999999)
( DK , RF are not allowed)

CLS_E01

The second number that you entered does not match the first. Please return and correct.

Note:

Trigger hard edit if CLS_N01A <> CLS_N01B.

CLS_D01C

(not applicable)

CLS_N01C

INTERVIEWER : Give the respondent the CLSA Information and Consent Form and the CLSA pamphlet to read and complete.
Press <Enter> to continue.

CLS_R01

Statistics Canada has been asked by Dalhousie University, McGill University and McMaster University, three universities leading a Canadian Longitudinal Study on Aging, to seek your permission to provide them with ^YOUR1 contact information, including ^YOUR1 name, address and telephone number, alternate contact and language information. As you will read from the consent form, Statistics Canada would also like your permission to disclose the information collected in this survey with these three universities (Dalhousie University, McGill University and McMaster University).
Please read this form completely before deciding if you wish to consent.
All survey information will be kept confidential by the Universities and be used for statistical purposes only.
INTERVIEWER : The respondent may ask if they can read the form over thoroughly and mail it back at a later date. This can be done, but do not prompt the mail–back as an option for the respondent.
Alternate contact information, collected in Exit, includes name, address and telephone number of a relative or friend who could help contact the respondent if the respondent moves or changes their telephone number. If the respondent wishes to provide CLSA with personal contact information but not alternate contact information, they may sign the consent form agreeing to share contact information and, in Exit, refuse to provide details of an alternate contact.
Press <Enter> to continue.

CLS_D02

(not applicable)

CLS_N02

INTERVIEWER : Did the respondent sign the CLSA consent form?
1 Yes
2 No
( DK , RF are not allowed)

CLS_N03

INTERVIEWER : Did the respondent choose to:
1 …share contact and survey information?
2 …share contact information only?
3 …share survey information only?
4 …NOT give permission to share any information?
5 …NOT complete the form?
6 …mail back the form? (Go to CLS_R07)
( DK , RF are not allowed)

CLS_N04

INTERVIEWER : What were the concerns or questions raised in regards to the three universities (Dalhousie University, McGill University and McMaster University) or the Canadian Longitudinal Study on Aging (CLSA)?
Mark all that apply.
1 Confidentiality / Privacy issues
2 Not interested
3 Commitment issues (health problems or no available time)
4 Language barrier (not official language)
5 Compensation issue (reimbursement for travel, for time spent)
6 Lack of information on CLSA project
7 Lack of information about any or all of the universities
8 Other – Specify (Go to CLS_S04)
9 No concerns / no questions raised (Go to CLS_END)
( DK , RF are not allowed)
Go to CLS_N05

CLS_S04

INTERVIEWER : Specify.
(80 spaces)
DK , RF

CLS_E04

You cannot select "No concerns / no questions raised" and another category. Please return and correct.

Note:

Trigger hard edit if CLS_N04 = 9 and any other response selected in CLS_N04.

CLS_C05

If more than one category is selected at CLS_N04, go to CLS_N05.
Otherwise, go to CLS_N06.

CLS_N05

INTERVIEWER : What was the single most important concern or question raised in regards to the three universities or the CLSA ?
1 Confidentiality / Privacy issues
2 Not interested
3 Commitment issues (health problems or no available time)
4 Language barrier (not official language)
5 Compensation issue (reimbursement for travel, for time spent)
6 Lack of information on CLSA project
7 Lack of information about any or all of the universities
8 ^CLS_S04
( DK , RF are not allowed)
Go to CLS_N06

Note:

At the time of the data processing, CLS_N05 = 8 will be given the value of "Other – Specify" from CLS_S4.

CLS_E05

You cannot select a response that was not selected in CLS_N04. Please return and correct.

Note:

Trigger hard edit if response in CLS_N05 was not selected in CLS_N04.
At the time of the data processing, if the interviewer only selected one response in CLS_N04, the variable in CLS_N05 will be given its value.

CLS_N06

INTERVIEWER : Which concerns or questions raised in regards to the three universities or the CLSA did you find difficult to explain?
Mark all that apply.
1 Confidentiality / Privacy issues
2 Not interested
3 Commitment issues (health problems or no available time)
4 Language barrier (not official language)
5 Compensation issue (reimbursement for travel, for time spent)
6 Lack of information on CLSA project
7 Lack of information about any or all of the universities
8 ^CLS_S04
9 No difficulty
DK
( RF not allowed)
Go to CLS_END

CLS_E06

You cannot select "No difficulty" and another category. Please return and correct.

Note:

Trigger hard edit if CLS_N06 = 9 (No difficulty) and any other response selected in CLS_N06.

CLS_R07

Whether you choose to consent or not, please mail back your signed Consent Form, within the next 10 days, using this pre–paid envelope. A Statistics Canada employee will call you to remind you if we do not receive it.
INTERVIEWER : Press <Enter> to continue.

CLS_END

Exit

The following module only includes part of the questions asked during the CCHS – Healthy Aging interview. It includes what we believe may be of interest for data users.
Possible future contact

PFC_R01

As part of this study, we may need to get in touch in the future.
INTERVIEWER: Press <Enter> to continue.
( DK , RF are not allowed)

PFC_END

Exit Introduction

EI_R01

Before we finish, I would like to ask you a few other questions.
INTERVIEWER: Press <Enter> to continue.
( DK , RF are not allowed)

EI_END

Permission to Share (if partial interview)

PS_BEG

Survey block
External variables required:
PROV: listing address province code

PS_D01

If PROV = 24, QUEBECPSE = "provincial ministries of health, the «Institut de la Statistique du Québec», Health Canada and the Public Health Agency of Canada.".
Otherwise, QUEBECPSE = "provincial ministries of health, Health Canada and the Public Health Agency of Canada.".

PS_R01

Statistics Canada would like your permission to share the information collected in this survey with ^QUEBECPSE.
INTERVIEWER : Press <Enter> to continue.

PS_Q01

All information will be kept confidential and used only for statistical purposes.
Do you agree to share the information provided?
1 Yes
2 No
DK , RF

PS_END

Permission to Link (if partial interview)

PL_BEG

Survey block
External variables required:
FNAME: first name of the selected respondent from ANDB block
PROV: listing address province code

PL_D01A

If PROV = 24, QUEBECHNE = "Statistics Canada, your provincial ministry of health and the « Institut de la Statistique du Québec »".
Otherwise, QUEBECHNE = "Statistics Canada and your provincial ministry of

PL_D01B

(not applicable)

PL_R01

^QUEBECHNE would like your permission to link information collected during this interview. This includes linking your survey information to ^YOUR2 past and continuing use of health services such as visits to hospitals, clinics and doctor’s offices.
INTERVIEWER : Press <Enter> to continue.

PL_Q01

This linked information will be kept confidential and used only for statistical purposes. Do we have your permission?
1 Yes
2 No
DK , RF

PL_END

Thank you 1

TY1_Q01

Thank you for your time.
INTERVIEWER: Press <Enter> to continue.
( DK , RF are not allowed)

TY1_END

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