Routing for UAS486
mainintro
This survey asks how you are feeling and if you provide care for a family member or friend.
Group of questions presented on the same screen
st_intro
We would like to know how you have been feeling recently.
In the past 30 days, how often have you been bothered by any of the following problems:
Subgroup of questions
st001 (Feeling nervous, anxious, or on edge)
Feeling nervous, anxious, or on edge
1 Not at all
2 Several days
3 More than half the days
4 Nearly every day
st002 (Not being able to stop or control worrying)
Not being able to stop or control worrying
1 Not at all
2 Several days
3 More than half the days
4 Nearly every day
st003 (Feeling down, depressed, or hopeless)
Feeling down, depressed, or hopeless
1 Not at all
2 Several days
3 More than half the days
4 Nearly every day
st004 (Little interest or pleasure in doing things)
Little interest or pleasure in doing things
1 Not at all
2 Several days
3 More than half the days
4 Nearly every day
End of subgroup of questions
End of group of questions
Group of questions presented on the same screen
st_intro2
In the past 30 days, how often have you felt:
Subgroup of questions
st005 (unable to control the important things in life)
That you were unable to control the important things in your life?
1 Never
2 Almost never
3 Sometimes
4 Fairly often
5 Very often
st006 (confident about ability to handle personal problems)
Confident about your ability to handle personal problems?
1 Never
2 Almost never
3 Sometimes
4 Fairly often
5 Very often
st007 (things were going your way)
That things were going your way?
1 Never
2 Almost never
3 Sometimes
4 Fairly often
5 Very often
st008 (difficulties were piling up so high could not overcome them)
Difficulties were piling up so high that you could not overcome them?
1 Never
2 Almost never
3 Sometimes
4 Fairly often
5 Very often
End of subgroup of questions
End of group of questions
Group of questions presented on the same screen
ln_intro
In the past 30 days, how often have you felt:
Subgroup of questions
ln001 (Lack of companionship)
Lack of companionship
1 Never
2 Almost never
3 Sometimes
4 Fairly often
5 Very often
ln002 (Alone)
Alone
1 Never
2 Almost never
3 Sometimes
4 Fairly often
5 Very often
ln003 (Left out)
Left out
1 Never
2 Almost never
3 Sometimes
4 Fairly often
5 Very often
ln004 (Isolated from others)
Isolated from others
1 Never
2 Almost never
3 Sometimes
4 Fairly often
5 Very often
End of subgroup of questions
End of group of questions
ca_intro
We are interested in how people in the U.S. provide care for a family member or close friend, and how caregivers are faring during these times.
ca001 (spend any time assisting a family member or close friend)
In the past 30 days, did you spend any time assisting a family member or close friend (e.g. parent, grandparent, wife, husband, adult or minor child with special needs, other family member, neighbor or close friend) with basic personal activities because they are unable to handle them without help?
By that we mean daily activities such as dressing, eating, bathing, paying bills, managing medication, food preparation, grocery shopping, doctor visits, emotional support, driving, and other types of personal assistance.
1 (YES) Yes
2 (NO) No
if ca001 = 1 then
ca002 (who caregiving for)
Who is the family member or close friend you are caregiving for?
If you provide care to more than one person, please indicate the person who requires the most time and energy from you as a caregiver.
1 Spouse/ partner
2 Parent
11 Parent-in-law
3 Son or daughter
4 Son or daughter-in-law
5 Grandparent
6 Grandchild
7 Sibling
8 Other relative
9 Friend/ companion, roommate
10 I am employed as a paid caregiver
if ca002 != 10 then
ca003 (paid to caregive)
Are you paid to provide care to that family member or close friend?
1 (YES) Yes
2 (NO) No
Group of questions presented on the same screen
ca004 (which conditionds or disabilities)
Which of the following conditions or disabilities, if any, apply to the person you are helping to care for? Please check all that apply, or write in an answer if it is not in the list below.
1 Alzheimer's disease, other dementia or cognitive impairment
2 Cancer
3 Stroke
4 Intellectual or developmental disability
5 Physical disability or injury
6 Mental health or psychiatric disability
7 Diabetes
8 Heart disease
9 Other chronic illness
10 Vision impairment, blindness
11 Other age-related impairments
14 Long-term effects of COVID-19 lasting more than 3 months
12 Other (please write in):
13 None
ca004_other (other which conditionds or disabilities)
STRING
End of group of questions
Group of questions presented on the same screen
ca005_intro
Does that family member or close friend need help with any of the following activities?
Subgroup of questions
ca005a (Getting across a room)
Getting across a room
1 (YES) Yes
2 (NO) No
ca005b (Bathing)
Bathing
1 (YES) Yes
2 (NO) No
ca005c (Eating)
Eating
1 (YES) Yes
2 (NO) No
ca005d ( Getting in and out of bed)
Getting in and out of bed
1 (YES) Yes
2 (NO) No
ca005e (Using the toilet)
Using the toilet
1 (YES) Yes
2 (NO) No
ca005f (Preparing a hot meal)
Preparing a hot meal
1 (YES) Yes
2 (NO) No
ca005g (Shopping for grocery and other necessities)
Shopping for grocery and other necessities
1 (YES) Yes
2 (NO) No
ca005h (Making phone calls)
Making phone calls
1 (YES) Yes
2 (NO) No
ca005i (Taking medication)
Taking medication
1 (YES) Yes
2 (NO) No
ca005j (Paying bills and keep tracking of expenses)
Paying bills and keep tracking of expenses
1 (YES) Yes
2 (NO) No
ca005k (Managing money)
Managing money
1 (YES) Yes
2 (NO) No
End of subgroup of questions
End of group of questions
if ca005a = 1 OR ca005b = 1 OR ca005c = 1 OR ca005d = 1 OR ca005e = 1 OR ca005f = 1 OR ca005g = 1 OR ca005h = 1 OR ca005i = 1 OR ca005j = 1 OR ca005k = 1 then
if ca005a = 1 then
End of if
if ca005b = 1 then
End of if
if ca005c = 1 then
End of if
if ca005d = 1 then
End of if
if ca005e = 1 then
End of if
if ca005f = 1 then
End of if
if ca005g = 1 then
End of if
if ca005h = 1 then
End of if
if ca005i = 1 then
End of if
if ca005j = 1 then
End of if
if ca005k = 1 then
End of if
ca006 (which activies assist with)
Which of these activities do you assist that family member or close friend with? Please check all that apply.
1 Getting across a room
2 Bathing
3 Eating
4 Getting in and out of bed
5 Using the toilet
6 Preparing a hot meal
7 Shopping for grocery and other necessities
8 Making phone calls
9 Taking medication
10 Paying bills and keep tracking of expenses
11 Managing money
12 None of the above
End of if
ca007 (where living person giving care for)
Where does the family member or close friend for whom you are a caregiver live?
1 With me
2 With another family member
3 By themselves
4 In a nursing home
5 Other
ca008 (who is caregiving)
Are you the only person assisting that family member or close friend or is somebody else providing care?
1 I am the only caregiver
2 I do most of the caregiving activities, but somebody else provides care occasionally
3 I equally share caregiving activities with somebody else
4 Somebody else does most of the caregiving activities, but I provide care occasionally
ca009 (how long care given)
For how long have you been providing care to that family member or close friend?
1 I have been providing care for more than a year
2 I have been providing care for less than a year
if ca009 = 1 then
ca009_years (years how long care given)
For how many years have you been providing care to that family member or close friend?
RANGE 1..120
elseif ca009 = 2 then
ca009_months (months how long care given)
For how many months have you been providing care to that family member or close friend?
RANGE 0..12
End of if
ca010 (hours per week giving care)
How many hours per week do you spend assisting that family member or close friend?
RANGE 1..168
Group of questions presented on the same screen
ca011_intro
Has your work or schooling changed due to your caregiving responsibilities?
Subgroup of questions
ca011a (stopped working)
I stopped working
1 (YES) Yes
2 (NO) No
ca011b (changed job)
I changed job
1 (YES) Yes
2 (NO) No
ca011c (dropped out of school)
I dropped out of school
1 (YES) Yes
2 (NO) No
ca011d (cut down on hours of work/schooling)
I cut down on hours of work/schooling
1 (YES) Yes
2 (NO) No
ca011e (other changes due caregiving)
Other changes, please describe:
1 (YES) Yes
2 (NO) No
End of subgroup of questions
ca011e_other (specify other changes due caregiving)
STRING
End of group of questions
if ca011a = 1 OR ca011b = 1 OR ca011c = 1 OR ca011d = 1 OR ca011e = 1 then
ca012 (when changes occurred)
When did your work or schooling change due to caregiving responsibilities? (If more than one change, please indicate the most recent)
1 2019 or before
2 In 2020
3 In 2021
4 In 2022
End of if
Group of questions presented on the same screen
ca013_intro
Have you done any of the following due to your caregiving responsibilities?
Subgroup of questions
ca013a (Missed doctor appointments)
Missed doctor appointments
1 (YES) Yes
2 (NO) No
ca013b (Reduced or stopped exercising)
Reduced or stopped exercising
1 (YES) Yes
2 (NO) No
ca013c (Reduced or stopped eating healthy meals)
Reduced or stopped eating healthy meals
1 (YES) Yes
2 (NO) No
ca013d (Reduced or stopped doing things you enjoyed)
Reduced or stopped doing things you enjoyed
1 (YES) Yes
2 (NO) No
End of subgroup of questions
End of group of questions
Else
ca014 (chances spend any time assisting family member or close friend)
Looking ahead to the next 5 years, what are the chances that you will spend any time assisting a family member or close friend (e.g. parent, grandparent, wife, husband, adult child, other family member, neighbor or close friend) with basic personal activities because they are unable to handle them without help?
By that we mean daily activities such as dressing, eating, bathing, paying bills, managing medication, food preparation, grocery shopping, doctor visits, emotional support, driving, and other types of personal assistance.
Please use the slider below where 0 corresponds to no chance at all and 100 to for sure.
End of if
if ca001 = 1 then
bu_questions := array(1 => "bu001", 2 => "bu002", 3 => "bu003", 4 => "bu004", 5 => "bu005", 6 => "bu006", 7 => "bu007", 8 => "bu008", 9 => "bu009", 10 => "bu010", 11 => "bu011", 12 => "bu012", 13 => "bu013", 14 => "bu014", 15 => "bu015", 16 => "bu016", 17 => "bu017", 18 => "bu018", 19 => "bu019", 20 => "bu020", 21 => "bu021", 22 => "bu022")
if sizeof(bu_order) = 0 then
bu_order := shuffleArray(array(1 => 1, 2 => 2, 3 => 3, 4 => 4, 5 => 5, 6 => 6, 7 => 7, 8 => 8, 9 => 9, 10 => 10, 11 => 11, 12 => 12, 13 => 13, 14 => 14, 15 => 15, 16 => 16, 17 => 17, 18 => 18, 19 => 19, 20 => 20, 21 => 21, 22 => 22))
End of if
Group of questions presented on the same screen
bu_intro
The following questions ask you about how providing care for that family member or close friend has affected you and your life, if at all.
Please tell us how much you agree or disagree with the following statements.
Subgroup of questions
Loop from 1 to 7
Value of question 'bu_questions[bu_order[cnt]]' asked as question
End of loop
End of subgroup of questions
End of group of questions
Group of questions presented on the same screen
bu_intro2
Please tell us how much you agree or disagree with the following statements.
Subgroup of questions
Loop from 8 to 14
Value of question 'bu_questions[bu_order[cnt]]' asked as question
End of loop
End of subgroup of questions
End of group of questions
Group of questions presented on the same screen
bu_intro2
Please tell us how much you agree or disagree with the following statements.
Subgroup of questions
Loop from 15 to 22
Value of question 'bu_questions[bu_order[cnt]]' asked as question
End of loop
End of subgroup of questions
End of group of questions
End of if
mpxassociations_intro
The final part of this survey asks questions about a different topic.
Here are a few questions about monkeypox. There are no right or wrong answers. We are only interested in your thoughts.
Group of questions presented on the same screen
mpxassociations_intro2
When you think of monkeypox, what other diseases come to mind? Please list up to three other diseases.
Loop from 1 to 3
mpxassociations (associated illness)
STRING
End of loop
End of group of questions
if mpxassociations[1] = empty AND mpxassociations[2] = empty AND mpxassociations[3] = empty then
mpx_warning
Please list at least one disease that comes to mind when you think of monkeypox.
End of if
mpxriskperception (risk perception monkeypox)
How worried are you that you might get sick from monkeypox?
1 Very worried
2 Somewhat worried
3 Not very worried
4 Not at all worried
mpxvaccination (chance get vaccinated monkeypox)
If a healthcare provider recommended that you get a monkeypox vaccine, and assuming one was available and free to you, what is the percent chance you would get vaccinated?
CS_001 (HOW PLEASANT INTERVIEW)
Could you tell us how interesting or uninteresting you found the questions in this interview?
1 Very interesting
2 Interesting
3 Neither interesting nor uninteresting
4 Uninteresting
5 Very uninteresting
CS_003 (comments)
Do you have any other comments on the survey? Please type these in the box below. (If you have no comments, please click next to complete this survey.)
STRING
dummy := doPayout(reward)