Form 156 - Supplemental Questionnaire
| File Name | Data as of | Population | Data collected | One row per | Rows |
|---|---|---|---|---|---|
| f156_ctos_inv.dat | 9/30/2016 | CT+OS | Ext2 | Participant | 74,852 |
ID - WHI Participant Common ID Col 1
F156VTYP - Visit Type Col 2
F156VY - Visit Year Col 3 Visit year in which this form was collected.
F156X2VY - Extension 2 visit year Col 4 WHI Extension 2 visit year for which this form was collected.
F156DAYS - F156 Days since randomization or enrollment Col 5
MOMBORNY - Year mother was born Col 6 What year was your mother born?
DADBORNY - Year father was born Col 7 What year was your father born?
WTCUR_X2 - Current weight, lbs Col 8 What is your current weight?
FRIENDSNUM - How many close friends Col 9 How many close friends do you have?
RELATIVESNUM - How many close relatives Col 10 How many close relatives do you have?
RAILINGS - Changes to home, railings or banisters Col 11 As people grow older they sometimes need to make changes to their home so that it is a safer and easier place to live. Please read the list below and mark any changes or additions you have made to your home for yourself or someone else. Be sure to mark all that apply. Railings or banisters.
GRABBARS - Changes to home, grab bars Col 12 As people grow older they sometimes need to make changes to their home so that it is a safer and easier place to live. Please read the list below and mark any changes or additions you have made to your home for yourself or someone else. Be sure to mark all that apply. Grab bars.
RAMPS - Changes to home, indoor or outdoor ramps Col 13 As people grow older they sometimes need to make changes to their home so that it is a safer and easier place to live. Please read the list below and mark any changes or additions you have made to your home for yourself or someone else. Be sure to mark all that apply. Indoor or outdoor ramps.
NONSLIP - Changes to home, non-slip surfaces Col 14 As people grow older they sometimes need to make changes to their home so that it is a safer and easier place to live. Please read the list below and mark any changes or additions you have made to your home for yourself or someone else. Be sure to mark all that apply. Non-slip surfaces.
TACKRUG - Changes to home, tacking down carpets/rugs Col 15 As people grow older they sometimes need to make changes to their home so that it is a safer and easier place to live. Please read the list below and mark any changes or additions you have made to your home for yourself or someone else. Be sure to mark all that apply. Tacking down carpets/rugs.
CLUTTER - Changes to home, decreasing clutter Col 16 As people grow older they sometimes need to make changes to their home so that it is a safer and easier place to live. Please read the list below and mark any changes or additions you have made to your home for yourself or someone else. Be sure to mark all that apply. Decreasing clutter.
LIGHTING - Changes to home, increasing lighting Col 17 As people grow older they sometimes need to make changes to their home so that it is a safer and easier place to live. Please read the list below and mark any changes or additions you have made to your home for yourself or someone else. Be sure to mark all that apply. Increasing lighting.
COUNTERHT - Changes to home, sink/counter heights Col 18 As people grow older they sometimes need to make changes to their home so that it is a safer and easier place to live. Please read the list below and mark any changes or additions you have made to your home for yourself or someone else. Be sure to mark all that apply. Sink/counter heights.
HOMEOTH - Changes to home, other Col 19 As people grow older they sometimes need to make changes to their home so that it is a safer and easier place to live. Please read the list below and mark any changes or additions you have made to your home for yourself or someone else. Be sure to mark all that apply. Other.
HOMENOCHNG - Changes to home, no changes Col 20 As people grow older they sometimes need to make changes to their home so that it is a safer and easier place to live. Please read the list below and mark any changes or additions you have made to your home for yourself or someone else. Be sure to mark all that apply. No changes.
FALLHOME - Fall at home last year Col 21 In the last year, did you fall at home?
EMERGDEVICE - Wear emergency contact device Col 22 Do you wear a device around your neck or wrist for contacting emergency help?
FLUSHOT - Flu shot in the past 12 months Col 23 During the past 12 months, have you had a seasonal flu shot?
PNEUMONIASHOT - Ever had a pneumonia shot Col 24 A pneumonia shot or pneumococcal vaccine is usually given only once or twice in a person's life and is different from the flu shot. Have you ever had a pneumonia shot?
SHINGLESVACC - Had the shingles vaccine Col 25 Have you had the shingles vaccine (also known as the zoster vaccine)?
PNEUMONIA - Pneumonia diagnosed by a physician Col 26 As an adult, have you had pneumonia diagnosed by a physician?
PNEUMLAST - Last pneumonia diagnosis Col 27 How long ago was your last pneumonia diagnosed?
UTI - Unirary tract infection Col 28 Has a health care provider ever told you that you had a urinary tract infection (bladder infection, cystitis, kidney infection, pyelonephritis)?
UTILAST - Last urinary tract infection Col 29 How long ago was your last urinary tract infection?
SHINGLES - Ever had shingles Col 30 Have you ever had shingles?
SHINGLESLAST - When had shingles Col 31 How long ago did you have shingles?
EYEDR - Last time saw an eye doctor Col 32 When was the last time you saw an eye doctor?
GLAUCOMA - Ever had glaucoma Col 33 Have you ever been told by an eye doctor that you have glaucoma?
GLAUCOMAAG - Age at glaucoma diagnosis Col 34 How old were you when diagnosed with glaucoma?
GLAUCDROPS - Glaucoma treatment, eye drops Col 35 Has your glaucoma been treated with any of the following? (Mark all that apply.) Eye drops.
GLAUCLASER - Glaucoma treatment, laser treatment Col 36 Has your glaucoma been treated with any of the following? (Mark all that apply.) Laser treatment.
GLAUCOTHSURG - Glaucoma treatment, other surgery Col 37 Has your glaucoma been treated with any of the following? (Mark all that apply.) Other surgery.
CATARACT - Ever had cataract surgery Col 38 Have you ever had surgery to remove cataracts?
CATARACTAG - Age at first cataract surgery Col 39 How old were you when you had your first cataract extraction surgery?
DIABRETIN - Ever had diabetic retinopathy Col 40 Have you ever been told by an eye doctor that you have diabetic retinopathy?
DIABRETINAG - Age at diabetic retinopathy diagnosis Col 41 How old were you when diagnosed with diabetic retinopathy?
DIABRETINLASER - Diabetic retinopathy treatment, laser treatment Col 42 Has your retinopathy been treated with any of the following? (Mark all that apply.) Laser treatment.
DIABRETINSURG - Diabetic retinopathy treatment, surgery/vitrectomy Col 43 Has your retinopathy been treated with any of the following? (Mark all that apply.) Surgery/vitrectomy.
DIABRETINSUPP - Diabetic retinopathy treatment, nutritional supplement Col 44 Has your retinopathy been treated with any of the following? (Mark all that apply.) Nutritional supplement.
DRYEYE - Ever had dry eye syndrome Col 45 Have you ever been told by an eye doctor that you have dry eye syndrome?
DRYEYEAG - Age at dry eye syndrome diagnosis Col 46 How old were you when diagnosed with dry eye syndrome?
DRYEYETEARS - Dry eye treatment, over the counter tears Col 47 Has your dry eye been treated with any of the following? (Mark all that apply.) Over-the-counter artificial tears.
DRYEYEDROPS - Dry eye treatment, medicating drops Col 48 Has your dry eye been treated with any of the following? (Mark all that apply.) Medicating drops (e.g., Restasis©).
DRYEYESUPP - Dry eye treatment, fish oil or omega-3 supplements Col 49 Has your dry eye been treated with any of the following? (Mark all that apply.) Fish oil or omega-3 supplements.
PROXY - Have chosen a health care proxy Col 50 Have you chosen a specific person you trust to make health care decisions for you in case you cannot speak for yourself?
PROXYWHO - Who is health care proxy Col 51 Who did you choose to make health care decisions for you? (Mark one.).
PROXYDISCUSS - Talked about end of life with health care proxy Col 52 Have you talked to the person you chose about the type of health care you want if you were very sick or near the end of your life? (Mark one.).
EOLPLAN - Plans made if cannot live alone Col 53 Have you made plans for what should happen if you become too sick to live on your own? (Mark one.).
LIVINGWILL - Advance directive, living will Col 54 An Advance Directive or Living Will are documents that let a person choose how she wants to be treated if she gets very sick and is near the end of her life. Have you filled out a written Advance Directive or Living Will?
PROVREFUSE - Refused as a patient because on Medicare Col 55 In the past year, has a health care provider refused to have you as a patient because you are on Medicare?
LT2MEALS - Eat fewer than 2 meals per day Col 56 I eat fewer than 2 meals per day.
EATALONE - Eat alone most of the time Col 57 I eat alone most of the time.
MOUTHPROB - Tooth or mouth problems making it hard to eat Col 58 I have tooth or mouth problems that make it hard for me to eat.
NOTABLEFEED - Not able to shop, cook and/or feed self Col 59 I am not always physically able to shop, cook and/or feed myself.
NOMONEYFOOD - Not enough money for food Col 60 I don’t always have enough money to buy the food I need.
CELLPHONE - Own a cell phone Col 61 Do you own a cell phone? Usage Notes: This is a lead-in question to F156 Q29.1 “Do you send or receive text messages on your phone?” (TEXTMSG), which has a high skip pattern error rate. The skip pattern rules are not applied. The sub-question may contain data when CELLPHONE is missing or 0 (No). You may wish to use the CELLPHONE and TEXTMSG variables in conjunction with each other.
TEXTMSG - Send or receive text messages Col 62 Do you send or receive text messages on your phone? Usage Notes: Sub-question of F156 Q29 “Do you own a cell phone?” (CELLPHONE). The skip pattern rule is not applied. NOTE: this question may contain data that violated the CELLPHONE question’s skip pattern rules where CELLPHONE was missing or 0 (No). You may wish to use the CELLPHONE and TEXTMSG variables in conjunction with each other.
COMPUTER - Use a computer Col 63 Do you use a computer (either at home or away from home)? Usage Notes: This is a lead-in question to F156 Q30.1 “Do you use it for email?” (EMAIL) and F156 Q30.2 “Do you use it for Internet?” (INTERNET), which have high skip pattern error rates. The skip pattern rules are not applied. The sub-questions may contain data when COMPUTER is missing or 0 (No). You may wish to use the COMPUTER, EMAIL and INTERNET variables in conjunction with each other.
EMAIL - Use a computer for email Col 64 Do you use it for e-mail? Usage Notes: Sub-question of F156 Q30 “Do you use a computer (either at home or away from home)?” (COMPUTER). The skip pattern rule is not applied. NOTE: this question may contain data that violated the COMPUTER question’s skip pattern rules where COMPUTER was missing or 0 (No). You may wish to use the COMPUTER, EMAIL and INTERNET variables in conjunction with each other.
INTERNET - Use a computer for internet Col 65 Do you use it for the internet? Usage Notes: Sub-question of F156 Q30 “Do you use a computer (either at home or away from home)?” (COMPUTER). The skip pattern rule is not applied. NOTE: this question may contain data that violated the COMPUTER question’s skip pattern rules where COMPUTER was missing or 0 (No). You may wish to use the COMPUTER, EMAIL and INTERNET variables in conjunction with each other.
SMARTDEVICE - Use smart phone, iPad or other device for email or the Internet Col 66 Even if you do not use a computer, do you use a “Smart phone,” iPad, or other device for email or the Internet?
INTERNETHEALTH - Use Internet for health info Col 67 Do you use the Internet to look for health information?
WHIWEBSITE - Looked at WHI website Col 68 Have you looked at the WHI website (www.whi.org)?
MOMAGE - Mother`s age at participant`s birth Col 69
DADAGE - Father`s age at participant`s birth Col 70
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