Routing for UAS494
ba_intro
Thank you for participating in the Brain Games study. As a last step before completing the study, please fill out this survey.
This is a shorter version of the survey you completed at the beginning of the study. It asks questions about your health and lifestyle that will help us study how people of different characteristics respond to brain games. As with all UAS surveys, we will carefully protect the privacy of the information you provide.
ba001 (rate physical health)
Compared to other people your own age, how would you rate your physical health?
1 Much worse than average
2 Worse than average
3 Average
4 Better than average
5 Much better than average
ba002 (rate physical fitness)
Compared to other people your own age, how would you rate your physical fitness?
1 Much worse than average
2 Worse than average
3 Average
4 Better than average
5 Much better than average
ba003 (rate psychological health)
Compared to other people your own age, how would you rate your psychological health?
1 Much worse than average
2 Worse than average
3 Average
4 Better than average
5 Much better than average
ba004 (rate memory and cognitive abilities)
Compared to other people your own age, how would you rate your memory and cognitive abilities?
1 Much worse than average
2 Worse than average
3 Average
4 Better than average
5 Much better than average
hc007 (take any medications)
Do you take any medications (prescription or nonprescription) on a regular basis (at least once a week)?
1 (YES) Yes
2 (NO) No
sl001 (how satisfied with sleep)
How satisfied are you with your sleep?
1 1 Very dissatisfied
2 2
3 3
4 4
5 5
6 6
7 7 Very satisfied
sl003 (how many caffeinated drinks consume each day)
On average, how many caffeinated drinks do you consume each day? (e.g., coffee, tea, soda)
1 0
2 1
3 2
4 3
5 More than 3
sl004 (how many alcoholic beverages consume each week)
How many alcoholic beverages do you consume each week? (e.g. glass of wine, 8 oz beer, shot of liquor)
1 0
2 1 - 2
3 3 - 4
4 5 - 6
5 More than 6
Group of questions presented on the same screen
ps003_intro
Using the scale below, please indicate the extent to which you agree or disagree with each of the following statements.
Subgroup of questions
ps003a (You have a certain amount of cognitive ability and you can't really do much to change it.)
You have a certain amount of cognitive ability and you can't really do much to change it
1 Strongly agree
2 Agree
3 Somewhat agree
4 Somewhat disagree
5 Strongly disagree
ps003b (Your cognitive ability is something that you can't change very much.)
Your cognitive ability is something that you can't change very much.
1 Strongly agree
2 Agree
3 Somewhat agree
4 Somewhat disagree
5 Strongly disagree
ps003c (You can learn new things, but you can't really change your basic intelligence and cognitive ability.)
You can learn new things, but you can't really change your basic intelligence and cognitive ability.
1 Strongly agree
2 Agree
3 Somewhat agree
4 Somewhat disagree
5 Strongly disagree
End of subgroup of questions
End of group of questions
CS_001 (HOW PLEASANT INTERVIEW)
Could you tell us how interesting or uninteresting you found the questions in this survey?
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.)
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