Routing for UAS545

maxcnt := 6
sectioncnt := 1
iskeck := 2
if randomizer_pay = empty then
if iskeck = 1 then
randomizer_pay := 1
Else
randomizer_pay_number := mt_rand(1,5)
if randomizer_pay_number in [1,2,3,4] then
randomizer_pay := 1
Else
randomizer_pay := 2
End of if
End of if
End of if
if iskeck = 1 then
main_intro_keck
Researchers at USC are working to develop a free smartphone app to help people improve their health and healthcare choices. We are interested in your opinion about which app features would be most useful to you and your willingness to share certain types of data in order to make those features possible.

The survey will also ask you some questions about your eye health and vision. Please answer to the best of your ability. All your answers will be kept confidential and not attributed specifically to you.
Else
main_intro
Researchers at USC are working to develop a free smartphone app to help people improve their health and healthcare choices. This app will not be a part of the UAS. We are interested in your opinion about which app features would be most useful to you and your willingness to share certain types of data in order to make those features possible.

The survey will also ask you some questions about your eye health and vision. Please answer to the best of your ability. As always, all your answers will be kept confidential and not attributed specifically to you.
End of if
di_intro2
Imagine that the University of Southern California (USC) developed a free smartphone app available to you that would empower you to learn about and improve your health and well-being.

For the app to work best, it would need to have as complete a picture of your health profile as possible.

All information you would give to the app will be kept strictly deidentified and confidential, and the app will not use the data for any other purpose without your direct permission.
if sizeof(di001_3_order) = 0 then
if iskeck = 1 then
di001_3_order := shuffleArray(array(1 => 1, 2 => 2, 3 => 3))
Else
di001_3_order := shuffleArray(array(1 => 1, 2 => 2, 3 => 3, 4 => 4))
End of if
End of if
if sizeof(di001_order) = 0 then
di001_order := shuffleArray(array(1 => 1, 2 => 2, 3 => 3, 4 => 4))
End of if
if sizeof(di002_order) = 0 then
di002_order := di001_order
End of if
if sizeof(di003_order) = 0 then
di003_order := di001_order
End of if
if iskeck != 1 then
if sizeof(di006_order) = 0 then
di006_order := di001_order
End of if
End of if
max := 4
if iskeck = 1 then
max := 3
End of if
Loop from 1 to MAX
if di001_3_order[cnt] = 1 then
di001 (how willing log on a weekly basis to answer questions)
Again, for the app to work best, it would need to have as complete a picture of your health profile as possible and all information you would give to the app will be kept strictly deidentified and confidential.

How willing would you be to log into the app on a weekly basis to answer a few questions (about 3 - 5 minutes) about how you are feeling?
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
elseif di001_3_order[cnt] = 2 then
di002 (how willing collect health information)
Again, for the app to work best, it would need to have as complete a picture of your health profile as possible and all information you would give to the app will be kept strictly deidentified and confidential.

How willing would you be to let the app collect health information from your smartphone, wearables, smart devices, and other consumer apps you might use? For example, a Fitbit or Apple Watch, Runkeeper or Noom Coach, etc.
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
elseif di001_3_order[cnt] = 3 then
di003 (how willing collect health information from health records)
Again, for the app to work best, it would need to have as complete a picture of your health profile as possible and all information you would give to the app will be kept strictly deidentified and confidential.

How willing would you be to let the app collect health information from your health records (for example, from your doctor's office)?
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
elseif di001_3_order[cnt] = 4 then
di006 (how willing app collect Global Positioning Satellite (GPS) location information)
Again, for the app to work best, it would need to have as complete a picture of your health profile as possible and all information you would give to the app will be kept strictly deidentified and confidential.

How willing would you be to let the app collect Global Positioning Satellite (GPS) location information from your smartphones or wearable devices?
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
End of if
End of loop
if di001_3_order[1] = 1 then
if di001 in [1,2,3] then
Group of questions presented on the same screen
di001_intro
How willing would you be to log into the app on a weekly basis to answer a few questions (about 3 - 5 minutes) about how you are feeling if:

Subgroup of questions
Loop from 1 to 4
if randomizer_pay = 1 and di001_order[cnt1] = 1 then
di001a (how willing log on app paid $5 a month)
The app paid you $5 a month?
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
elseif di001_order[cnt1] = 2 then
di001b (how willing log on help app learn make better health recommendations)
The information would help the app learn how to make better health recommendations for other people like you (for example, those who come from similar backgrounds or those who may have the same diagnoses as you)?
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
elseif di001_order[cnt1] = 3 then
di001c (how willing log on help app make personalized recommendations)
The information would help the app make personalized recommendations for you when you are not feeling well (for example, the app may recommend an over-the-counter treatment or that you schedule an appointment with the right healthcare provider based on your symptoms?)
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
elseif di001_order[cnt1] = 4 then
di001d (how willing log on help healthcare providers improve quality of care)
The information would help your healthcare providers improve the quality of your care?
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
End of if
End of loop
End of subgroup of questions
End of group of questions
End of if
elseif di001_3_order[1] = 2 then
if di002 in [1,2,3] then
Group of questions presented on the same screen
di002_intro
How willing would you be to let the app collect health information from your smartphone, wearables, smart devices, and other consumer apps you might use if:

Subgroup of questions
Loop from 1 to 4
if randomizer_pay = 1 and di002_order[cnt2] = 1 then
di002a (collect health information from smartphone paid $5 a month)
The app paid you $5 a month?
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
elseif di002_order[cnt2] = 2 then
di002b (collect health information from smartphone help app learn make better health recommendations)
The information would help the app learn how to make better health recommendations for other people like you (for example, those who come from similar backgrounds or those who may have the same diagnoses as you)?
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
elseif di002_order[cnt2] = 3 then
di002c (collect health information from smartphone help app make personalized recommendations)
The information would help the app make personalized recommendations for you when you are not feeling well (for example, the app may recommend an over-the-counter treatment or that you schedule an appointment with the right healthcare provider based on your symptoms?)
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
elseif di002_order[cnt2] = 4 then
di002d (collect health information from smartphone help healthcare providers improve quality of care)
The information would help your healthcare providers improve the quality of your care?
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
End of if
End of loop
End of subgroup of questions
End of group of questions
End of if
elseif di001_3_order[1] = 3 then
if di003 in [1,2,3] then
Group of questions presented on the same screen
di003_intro
How willing would you be to let the app collect health information from your health records (for example, from your doctor's office) if:

Subgroup of questions
Loop from 1 to 4
if randomizer_pay = 1 and di003_order[cnt3] = 1 then
di003a (collect health information from health records paid $5 a month)
The app paid you $5 a month?
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
elseif di003_order[cnt3] = 2 then
di003b (collect health information from health records help app learn make better health recommendations)
The information would help the app learn how to make better health recommendations for other people like you (for example, those who come from similar backgrounds or those who may have the same diagnoses as you)?
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
elseif di003_order[cnt3] = 3 then
di003c (collect health information from health records help app make personalized recommendations)
The information would help the app make personalized recommendations for you when you are not feeling well (for example, the app may recommend an over-the-counter treatment or that you schedule an appointment with the right healthcare provider based on your symptoms?)
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
elseif di003_order[cnt3] = 4 then
di003d (collect health information from health records help healthcare providers improve quality of care)
The information would help your healthcare providers improve the quality of your care?
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
End of if
End of loop
End of subgroup of questions
End of group of questions
End of if
elseif iskeck != 1 and di001_3_order[1] = 4 then
if di006 in [1,2,3] then
Group of questions presented on the same screen
di006_intro
How willing would you be to let the app collect GPS location information from your smartphones or wearable devices if:

Subgroup of questions
Loop from 1 to 4
if randomizer_pay = 1 and di006_order[cnt5] = 1 then
di006a (collect GPS paid $5 a month)
The app paid you $5 a month?
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
elseif di006_order[cnt5] = 2 then
di006b (collect GPS help app learn make better health recommendations)
The information would help the app learn how to make better health recommendations for other people like you (for example, those who come from similar backgrounds or those who may have the same diagnoses as you)?
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
elseif di006_order[cnt5] = 3 then
di006c (collect GPS help app make personalized recommendations)
The information would help the app make personalized recommendations for you when you are not feeling well (for example, the app may recommend an over-the-counter treatment or that you schedule an appointment with the right healthcare provider based on your symptoms?)
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
elseif di006_order[cnt5] = 4 then
di006d (collect GPS help healthcare providers improve quality of care)
The information would help your healthcare providers improve the quality of your care?
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
End of if
End of loop
End of subgroup of questions
End of group of questions
End of if
End of if
if di001_3_order[2] = 1 then
if di001 in [1,2,3] then
Group of questions presented on the same screen
di001_intro
How willing would you be to log into the app on a weekly basis to answer a few questions (about 3 - 5 minutes) about how you are feeling if:

Subgroup of questions
Loop from 1 to 4
if randomizer_pay = 1 and di001_order[cnt1] = 1 then
di001a (how willing log on app paid $5 a month)
The app paid you $5 a month?
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
elseif di001_order[cnt1] = 2 then
di001b (how willing log on help app learn make better health recommendations)
The information would help the app learn how to make better health recommendations for other people like you (for example, those who come from similar backgrounds or those who may have the same diagnoses as you)?
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
elseif di001_order[cnt1] = 3 then
di001c (how willing log on help app make personalized recommendations)
The information would help the app make personalized recommendations for you when you are not feeling well (for example, the app may recommend an over-the-counter treatment or that you schedule an appointment with the right healthcare provider based on your symptoms?)
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
elseif di001_order[cnt1] = 4 then
di001d (how willing log on help healthcare providers improve quality of care)
The information would help your healthcare providers improve the quality of your care?
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
End of if
End of loop
End of subgroup of questions
End of group of questions
End of if
elseif di001_3_order[2] = 2 then
if di002 in [1,2,3] then
Group of questions presented on the same screen
di002_intro
How willing would you be to let the app collect health information from your smartphone, wearables, smart devices, and other consumer apps you might use if:

Subgroup of questions
Loop from 1 to 4
if randomizer_pay = 1 and di002_order[cnt2] = 1 then
di002a (collect health information from smartphone paid $5 a month)
The app paid you $5 a month?
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
elseif di002_order[cnt2] = 2 then
di002b (collect health information from smartphone help app learn make better health recommendations)
The information would help the app learn how to make better health recommendations for other people like you (for example, those who come from similar backgrounds or those who may have the same diagnoses as you)?
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
elseif di002_order[cnt2] = 3 then
di002c (collect health information from smartphone help app make personalized recommendations)
The information would help the app make personalized recommendations for you when you are not feeling well (for example, the app may recommend an over-the-counter treatment or that you schedule an appointment with the right healthcare provider based on your symptoms?)
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
elseif di002_order[cnt2] = 4 then
di002d (collect health information from smartphone help healthcare providers improve quality of care)
The information would help your healthcare providers improve the quality of your care?
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
End of if
End of loop
End of subgroup of questions
End of group of questions
End of if
elseif di001_3_order[2] = 3 then
if di003 in [1,2,3] then
Group of questions presented on the same screen
di003_intro
How willing would you be to let the app collect health information from your health records (for example, from your doctor's office) if:

Subgroup of questions
Loop from 1 to 4
if randomizer_pay = 1 and di003_order[cnt3] = 1 then
di003a (collect health information from health records paid $5 a month)
The app paid you $5 a month?
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
elseif di003_order[cnt3] = 2 then
di003b (collect health information from health records help app learn make better health recommendations)
The information would help the app learn how to make better health recommendations for other people like you (for example, those who come from similar backgrounds or those who may have the same diagnoses as you)?
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
elseif di003_order[cnt3] = 3 then
di003c (collect health information from health records help app make personalized recommendations)
The information would help the app make personalized recommendations for you when you are not feeling well (for example, the app may recommend an over-the-counter treatment or that you schedule an appointment with the right healthcare provider based on your symptoms?)
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
elseif di003_order[cnt3] = 4 then
di003d (collect health information from health records help healthcare providers improve quality of care)
The information would help your healthcare providers improve the quality of your care?
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
End of if
End of loop
End of subgroup of questions
End of group of questions
End of if
elseif iskeck != 1 and di001_3_order[2] = 4 then
if di006 in [1,2,3] then
Group of questions presented on the same screen
di006_intro
How willing would you be to let the app collect GPS location information from your smartphones or wearable devices if:

Subgroup of questions
Loop from 1 to 4
if randomizer_pay = 1 and di006_order[cnt5] = 1 then
di006a (collect GPS paid $5 a month)
The app paid you $5 a month?
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
elseif di006_order[cnt5] = 2 then
di006b (collect GPS help app learn make better health recommendations)
The information would help the app learn how to make better health recommendations for other people like you (for example, those who come from similar backgrounds or those who may have the same diagnoses as you)?
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
elseif di006_order[cnt5] = 3 then
di006c (collect GPS help app make personalized recommendations)
The information would help the app make personalized recommendations for you when you are not feeling well (for example, the app may recommend an over-the-counter treatment or that you schedule an appointment with the right healthcare provider based on your symptoms?)
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
elseif di006_order[cnt5] = 4 then
di006d (collect GPS help healthcare providers improve quality of care)
The information would help your healthcare providers improve the quality of your care?
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
End of if
End of loop
End of subgroup of questions
End of group of questions
End of if
End of if
if di001_3_order[3] = 1 then
if di001 in [1,2,3] then
Group of questions presented on the same screen
di001_intro
How willing would you be to log into the app on a weekly basis to answer a few questions (about 3 - 5 minutes) about how you are feeling if:

Subgroup of questions
Loop from 1 to 4
if randomizer_pay = 1 and di001_order[cnt1] = 1 then
di001a (how willing log on app paid $5 a month)
The app paid you $5 a month?
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
elseif di001_order[cnt1] = 2 then
di001b (how willing log on help app learn make better health recommendations)
The information would help the app learn how to make better health recommendations for other people like you (for example, those who come from similar backgrounds or those who may have the same diagnoses as you)?
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
elseif di001_order[cnt1] = 3 then
di001c (how willing log on help app make personalized recommendations)
The information would help the app make personalized recommendations for you when you are not feeling well (for example, the app may recommend an over-the-counter treatment or that you schedule an appointment with the right healthcare provider based on your symptoms?)
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
elseif di001_order[cnt1] = 4 then
di001d (how willing log on help healthcare providers improve quality of care)
The information would help your healthcare providers improve the quality of your care?
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
End of if
End of loop
End of subgroup of questions
End of group of questions
End of if
elseif di001_3_order[3] = 2 then
if di002 in [1,2,3] then
Group of questions presented on the same screen
di002_intro
How willing would you be to let the app collect health information from your smartphone, wearables, smart devices, and other consumer apps you might use if:

Subgroup of questions
Loop from 1 to 4
if randomizer_pay = 1 and di002_order[cnt2] = 1 then
di002a (collect health information from smartphone paid $5 a month)
The app paid you $5 a month?
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
elseif di002_order[cnt2] = 2 then
di002b (collect health information from smartphone help app learn make better health recommendations)
The information would help the app learn how to make better health recommendations for other people like you (for example, those who come from similar backgrounds or those who may have the same diagnoses as you)?
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
elseif di002_order[cnt2] = 3 then
di002c (collect health information from smartphone help app make personalized recommendations)
The information would help the app make personalized recommendations for you when you are not feeling well (for example, the app may recommend an over-the-counter treatment or that you schedule an appointment with the right healthcare provider based on your symptoms?)
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
elseif di002_order[cnt2] = 4 then
di002d (collect health information from smartphone help healthcare providers improve quality of care)
The information would help your healthcare providers improve the quality of your care?
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
End of if
End of loop
End of subgroup of questions
End of group of questions
End of if
elseif di001_3_order[3] = 3 then
if di003 in [1,2,3] then
Group of questions presented on the same screen
di003_intro
How willing would you be to let the app collect health information from your health records (for example, from your doctor's office) if:

Subgroup of questions
Loop from 1 to 4
if randomizer_pay = 1 and di003_order[cnt3] = 1 then
di003a (collect health information from health records paid $5 a month)
The app paid you $5 a month?
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
elseif di003_order[cnt3] = 2 then
di003b (collect health information from health records help app learn make better health recommendations)
The information would help the app learn how to make better health recommendations for other people like you (for example, those who come from similar backgrounds or those who may have the same diagnoses as you)?
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
elseif di003_order[cnt3] = 3 then
di003c (collect health information from health records help app make personalized recommendations)
The information would help the app make personalized recommendations for you when you are not feeling well (for example, the app may recommend an over-the-counter treatment or that you schedule an appointment with the right healthcare provider based on your symptoms?)
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
elseif di003_order[cnt3] = 4 then
di003d (collect health information from health records help healthcare providers improve quality of care)
The information would help your healthcare providers improve the quality of your care?
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
End of if
End of loop
End of subgroup of questions
End of group of questions
End of if
elseif iskeck != 1 and di001_3_order[3] = 4 then
if di006 in [1,2,3] then
Group of questions presented on the same screen
di006_intro
How willing would you be to let the app collect GPS location information from your smartphones or wearable devices if:

Subgroup of questions
Loop from 1 to 4
if randomizer_pay = 1 and di006_order[cnt5] = 1 then
di006a (collect GPS paid $5 a month)
The app paid you $5 a month?
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
elseif di006_order[cnt5] = 2 then
di006b (collect GPS help app learn make better health recommendations)
The information would help the app learn how to make better health recommendations for other people like you (for example, those who come from similar backgrounds or those who may have the same diagnoses as you)?
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
elseif di006_order[cnt5] = 3 then
di006c (collect GPS help app make personalized recommendations)
The information would help the app make personalized recommendations for you when you are not feeling well (for example, the app may recommend an over-the-counter treatment or that you schedule an appointment with the right healthcare provider based on your symptoms?)
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
elseif di006_order[cnt5] = 4 then
di006d (collect GPS help healthcare providers improve quality of care)
The information would help your healthcare providers improve the quality of your care?
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
End of if
End of loop
End of subgroup of questions
End of group of questions
End of if
End of if
if di001_3_order[4] = 1 then
if di001 in [1,2,3] then
Group of questions presented on the same screen
di001_intro
How willing would you be to log into the app on a weekly basis to answer a few questions (about 3 - 5 minutes) about how you are feeling if:

Subgroup of questions
Loop from 1 to 4
if randomizer_pay = 1 and di001_order[cnt1] = 1 then
di001a (how willing log on app paid $5 a month)
The app paid you $5 a month?
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
elseif di001_order[cnt1] = 2 then
di001b (how willing log on help app learn make better health recommendations)
The information would help the app learn how to make better health recommendations for other people like you (for example, those who come from similar backgrounds or those who may have the same diagnoses as you)?
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
elseif di001_order[cnt1] = 3 then
di001c (how willing log on help app make personalized recommendations)
The information would help the app make personalized recommendations for you when you are not feeling well (for example, the app may recommend an over-the-counter treatment or that you schedule an appointment with the right healthcare provider based on your symptoms?)
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
elseif di001_order[cnt1] = 4 then
di001d (how willing log on help healthcare providers improve quality of care)
The information would help your healthcare providers improve the quality of your care?
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
End of if
End of loop
End of subgroup of questions
End of group of questions
End of if
elseif di001_3_order[4] = 2 then
if di002 in [1,2,3] then
Group of questions presented on the same screen
di002_intro
How willing would you be to let the app collect health information from your smartphone, wearables, smart devices, and other consumer apps you might use if:

Subgroup of questions
Loop from 1 to 4
if randomizer_pay = 1 and di002_order[cnt2] = 1 then
di002a (collect health information from smartphone paid $5 a month)
The app paid you $5 a month?
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
elseif di002_order[cnt2] = 2 then
di002b (collect health information from smartphone help app learn make better health recommendations)
The information would help the app learn how to make better health recommendations for other people like you (for example, those who come from similar backgrounds or those who may have the same diagnoses as you)?
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
elseif di002_order[cnt2] = 3 then
di002c (collect health information from smartphone help app make personalized recommendations)
The information would help the app make personalized recommendations for you when you are not feeling well (for example, the app may recommend an over-the-counter treatment or that you schedule an appointment with the right healthcare provider based on your symptoms?)
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
elseif di002_order[cnt2] = 4 then
di002d (collect health information from smartphone help healthcare providers improve quality of care)
The information would help your healthcare providers improve the quality of your care?
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
End of if
End of loop
End of subgroup of questions
End of group of questions
End of if
elseif di001_3_order[4] = 3 then
if di003 in [1,2,3] then
Group of questions presented on the same screen
di003_intro
How willing would you be to let the app collect health information from your health records (for example, from your doctor's office) if:

Subgroup of questions
Loop from 1 to 4
if randomizer_pay = 1 and di003_order[cnt3] = 1 then
di003a (collect health information from health records paid $5 a month)
The app paid you $5 a month?
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
elseif di003_order[cnt3] = 2 then
di003b (collect health information from health records help app learn make better health recommendations)
The information would help the app learn how to make better health recommendations for other people like you (for example, those who come from similar backgrounds or those who may have the same diagnoses as you)?
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
elseif di003_order[cnt3] = 3 then
di003c (collect health information from health records help app make personalized recommendations)
The information would help the app make personalized recommendations for you when you are not feeling well (for example, the app may recommend an over-the-counter treatment or that you schedule an appointment with the right healthcare provider based on your symptoms?)
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
elseif di003_order[cnt3] = 4 then
di003d (collect health information from health records help healthcare providers improve quality of care)
The information would help your healthcare providers improve the quality of your care?
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
End of if
End of loop
End of subgroup of questions
End of group of questions
End of if
elseif iskeck != 1 and di001_3_order[4] = 4 then
if di006 in [1,2,3] then
Group of questions presented on the same screen
di006_intro
How willing would you be to let the app collect GPS location information from your smartphones or wearable devices if:

Subgroup of questions
Loop from 1 to 4
if randomizer_pay = 1 and di006_order[cnt5] = 1 then
di006a (collect GPS paid $5 a month)
The app paid you $5 a month?
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
elseif di006_order[cnt5] = 2 then
di006b (collect GPS help app learn make better health recommendations)
The information would help the app learn how to make better health recommendations for other people like you (for example, those who come from similar backgrounds or those who may have the same diagnoses as you)?
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
elseif di006_order[cnt5] = 3 then
di006c (collect GPS help app make personalized recommendations)
The information would help the app make personalized recommendations for you when you are not feeling well (for example, the app may recommend an over-the-counter treatment or that you schedule an appointment with the right healthcare provider based on your symptoms?)
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
elseif di006_order[cnt5] = 4 then
di006d (collect GPS help healthcare providers improve quality of care)
The information would help your healthcare providers improve the quality of your care?
1 Very unwilling
2 Somewhat unwilling
3 Unsure
4 Somewhat willing
5 Very willing
End of if
End of loop
End of subgroup of questions
End of group of questions
End of if
End of if
Loop from 1 to MAX
if di001_3_order[cnt6] = 1 then
if di001 in [1,2,3] and ((di001a in [1,2,3] OR di001a = empty) and (di001b in [1,2,3] OR di001b = empty) and (di001c in [1,2,3] OR di001c = empty) and (di001d in [1,2,3] OR di001d = empty)) then
End of if
elseif di001_3_order[cnt6] = 2 then
if di002 in [1,2,3] and ((di002a in [1,2,3] OR di002a = empty) and (di002b in [1,2,3] OR di002b = empty) and (di002c in [1,2,3] OR di002c = empty) and (di002d in [1,2,3] OR di002d = empty)) then
End of if
elseif di001_3_order[cnt6] = 3 then
if di003 in [1,2,3] and ((di003a in [1,2,3] OR di003a = empty) and (di003b in [1,2,3] OR di003b = empty) and (di003c in [1,2,3] OR di003c = empty) and (di003d in [1,2,3] OR di003d = empty)) then
End of if
elseif di001_3_order[cnt6] = 4 then
if di006 in [1,2,3] and ((di006a in [1,2,3] OR di006a = empty) and (di006b in [1,2,3] OR di006b = empty) and (di006c in [1,2,3] OR di006c = empty) and (di006d in [1,2,3] OR di006d = empty)) then
End of if
End of if
End of loop
if sizeof(di004_order) = 0 then
di004_order := shuffleArray(array(1 => 1, 2 => 2, 3 => 3, 4 => 4, 5 => 5, 6 => 6, 7 => 7, 8 => 8, 9 => 9))
di004_order[10] := 10
End of if
Group of questions presented on the same screen
Subgroup of questions
Loop from 1 to 9
if di004_order[cnt] = 1 then
elseif di004_order[cnt] = 2 then
elseif di004_order[cnt] = 3 then
elseif di004_order[cnt] = 4 then
elseif di004_order[cnt] = 5 then
elseif di004_order[cnt] = 6 then
elseif di004_order[cnt] = 7 then
elseif di004_order[cnt] = 8 then
elseif di004_order[cnt] = 9 then
End of if
End of loop
End of subgroup of questions
End of group of questions
if sizeof(di005_order) = 0 then
di005_order := di004_order
di005_order[11] := 11
End of if
sectioncnt := 2
if iskeck = 1 then
pm_intro
The next set of questions will ask you about your eye health and any vision symptoms you may be experiencing.
Else
pm_intro2
The next set of questions will ask you about your eye health and any vision symptoms you may be experiencing. This survey is not intended to diagnose vision problems. If you have any concerns about your vision or your health, please see your doctor.
End of if
if sizeof(pm001_order) = 0 then
pm001_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))
pm001_order[12] := 12
pm001_order[13] := 13
End of if
Group of questions presented on the same screen
pm001 (any eye diseases or conditions)
Has a doctor ever told you that you have any of the below eye diseases or conditions: (please check all that apply)
1 Cornea problem, affecting the front clear part of the eye
2 Glaucoma, a problem with eye pressure that affects the optic nerve
3 Cataract, cloudy areas in the lens of the eye that can impede your vision
4 Diabetes-related eye disease like diabetic retinopathy
5 Macular degeneration, an age-related disease of the light-sensing nerves in the back of your eye
6 Retinal vessel blockage, which can result in bleeding and swelling within the light-sensing nerves in the back of your eye
7 Retinal tear or detachment, a problem with separation of the light-sensing layer of nerves from the back of your eye
8 An eye injury or infection
9 Uveitis or scleritis, a problem with inflammation affecting the eye
10 A problem with the eyelid
11 Problems with your vision that require glasses or contacts such as near-sightedness (myopia), far-sightedness (hyperopia), difficulty reading up close (presbyopia), or astigmatism
12 Other, please specify:
13 I have never been told by a doctor that I have an eye disease or condition
pm001_other (other eye diseases or conditions)
STRING
End of group of questions
if pm001 = response and pm001 != 13 then
Group of questions presented on the same screen
pm002_intro
Do you feel as if your diagnosed eye disease(s) or condition(s) has gotten better or worse over the last 6 months?

Subgroup of questions
Loop from 1 to 12
if pm001_order[cnt] = 1 AND 1 in pm001 then
pm002a (better worse Cornea problem)
Cornea problem, affecting the front clear part of the eye
1 Better
2 Worse
3 Stayed about the same
4 I don't know
End of if
if pm001_order[cnt] = 2 AND 2 in pm001 then
pm002b (better worse Glaucoma)
Glaucoma, a problem with eye pressure that affects the optic nerve
1 Better
2 Worse
3 Stayed about the same
4 I don't know
End of if
if pm001_order[cnt] = 3 AND 3 in pm001 then
pm002c (better worse Cataract)
Cataract, cloudy areas in the lens of the eye that can impede your vision
1 Better
2 Worse
3 Stayed about the same
4 I don't know
End of if
if pm001_order[cnt] = 4 AND 4 in pm001 then
pm002d (better worse Diabetes-related eye disease like diabetic retinopathy)
Diabetes-related eye disease like diabetic retinopathy
1 Better
2 Worse
3 Stayed about the same
4 I don't know
End of if
if pm001_order[cnt] = 5 AND 5 in pm001 then
pm002e (better worse Macular degeneration)
Macular degeneration, an age-related disease of the light-sensing nerves in the back of your eye
1 Better
2 Worse
3 Stayed about the same
4 I don't know
End of if
if pm001_order[cnt] = 6 AND 6 in pm001 then
pm002f (better worse Retinal vessel blockage)
Retinal vessel blockage, which can result in bleeding and swelling within the light-sensing nerves in the back of your eye
1 Better
2 Worse
3 Stayed about the same
4 I don't know
End of if
if pm001_order[cnt] = 7 AND 7 in pm001 then
pm002g (better worse Retinal tear or detachment)
Retinal tear or detachment, a problem with separation of the light-sensing layer of nerves from the back of your eye
1 Better
2 Worse
3 Stayed about the same
4 I don't know
End of if
if pm001_order[cnt] = 8 AND 8 in pm001 then
pm002h (better worse An eye injury or infection)
An eye injury or infection
1 Better
2 Worse
3 Stayed about the same
4 I don't know
End of if
if pm001_order[cnt] = 9 AND 9 in pm001 then
pm002i (better worse Uveitis or scleritis, a problem with inflammation affecting the eye)
Uveitis or scleritis, a problem with inflammation affecting the eye
1 Better
2 Worse
3 Stayed about the same
4 I don't know
End of if
if pm001_order[cnt] = 10 AND 10 in pm001 then
pm002j (better worse A problem with the eyelid)
A problem with the eyelid
1 Better
2 Worse
3 Stayed about the same
4 I don't know
End of if
if pm001_order[cnt] = 11 AND 11 in pm001 then
pm002k (better worse Problems with your vision that require glasses or contacts)
Problems with your vision that require glasses or contacts such as near-sightedness (myopia), far-sightedness (hyperopia), difficulty reading up close (presbyopia), or astigmatism
1 Better
2 Worse
3 Stayed about the same
4 I don't know
End of if
if pm001_order[cnt] = 12 AND 12 in pm001 then
pm002l (better worse other problems with your vision that require glasses or contacts)
Other ([other eye diseases or conditions[]])
1 Better
2 Worse
3 Stayed about the same
4 I don't know
End of if
End of loop
End of subgroup of questions
End of group of questions
End of if
pm003 (last time saw eye care provider)
When was the last time you saw an eye care provider such as an ophthalmologist or optometrist?
1 0-3 months
2 4-6 months
3 7-12 months
4 Greater than 12 months
5 I have never seen an eye care provider
6 I don't know
pm004 (doctor ever told have diabetes or high blood sugar)
Has a doctor ever told you that you have diabetes or high blood sugar?
1 Yes
2 No
3 I don't know
sectioncnt := 3
if sizeof(nm001_order) = 0 then
nm001_order := shuffleArray(array(1 => 1, 2 => 2, 3 => 3, 4 => 4, 5 => 5, 6 => 6, 7 => 7))
nm001_order[8] := 8
nm001_order[9] := 9
nm001_order[10] := 10
End of if
Group of questions presented on the same screen
nm001 (new vision problems in last six months)
Have you noticed any new vision problems in the last six months? (please check all that apply)
1 New flashes of light in your vision
2 New spots in front of your eye ("floaters")
3 New distortion of vision or blurry vision
4 New darkening or graying out of vision
5 New double vision
6 New glare or haloes
7 New droopy eyelid
8 Other, please specify:
9 I have not noticed any new vision problems in the past 6 months
10 I don't know
nm001_other (other new vision problems in last six months)
STRING
End of group of questions
if nm001 = response and nm001 != 9 and nm001 != 10 then
Group of questions presented on the same screen
nm002_intro
Over the last six months, how often do/does your new vision problem(s) occur?

Subgroup of questions
Loop from 1 to 8
if nm001_order[cnt] = 1 and 1 in nm001 then
nm002a (how often New flashes of light in your vision)
New flashes of light in your vision
1 Constantly
2 Several times per day
3 Several times per week
4 Several times per month
5 Less than once per month, but several times over the last 6 months
6 Only once or twice in the last 6 months
End of if
if nm001_order[cnt] = 2 and 2 in nm001 then
nm002b (how often New spots in front of your eye ("floaters"))
New spots in front of your eye ("floaters")
1 Constantly
2 Several times per day
3 Several times per week
4 Several times per month
5 Less than once per month, but several times over the last 6 months
6 Only once or twice in the last 6 months
End of if
if nm001_order[cnt] = 3 and 3 in nm001 then
nm002c (how often New distortion of vision or blurry vision)
New distortion of vision or blurry vision
1 Constantly
2 Several times per day
3 Several times per week
4 Several times per month
5 Less than once per month, but several times over the last 6 months
6 Only once or twice in the last 6 months
End of if
if nm001_order[cnt] = 4 and 4 in nm001 then
nm002d (how often New darkening or graying out of vision )
New darkening or graying out of vision
1 Constantly
2 Several times per day
3 Several times per week
4 Several times per month
5 Less than once per month, but several times over the last 6 months
6 Only once or twice in the last 6 months
End of if
if nm001_order[cnt] = 5 and 5 in nm001 then
nm002e (how often New double vision)
New double vision
1 Constantly
2 Several times per day
3 Several times per week
4 Several times per month
5 Less than once per month, but several times over the last 6 months
6 Only once or twice in the last 6 months
End of if
if nm001_order[cnt] = 6 and 6 in nm001 then
nm002f (how often New glare or haloes)
New glare or haloes
1 Constantly
2 Several times per day
3 Several times per week
4 Several times per month
5 Less than once per month, but several times over the last 6 months
6 Only once or twice in the last 6 months
End of if
if nm001_order[cnt] = 7 and 7 in nm001 then
nm002g (how often New droopy eyelid)
New droopy eyelid
1 Constantly
2 Several times per day
3 Several times per week
4 Several times per month
5 Less than once per month, but several times over the last 6 months
6 Only once or twice in the last 6 months
End of if
if nm001_order[cnt] = 8 and 8 in nm001 then
nm002h (how often Other new symptom)
Other ([other new vision problems in last six months[]])
1 Constantly
2 Several times per day
3 Several times per week
4 Several times per month
5 Less than once per month, but several times over the last 6 months
6 Only once or twice in the last 6 months
End of if
End of loop
End of subgroup of questions
End of group of questions
Group of questions presented on the same screen
nm003_intro
Over the last 30 days, has/have your new vision problem(s), gotten better, worse, or stayed the same?

Subgroup of questions
Loop from 1 to 8
if nm001_order[cnt] = 1 and 1 in nm001 then
nm003a (better worse New flashes of light in your vision)
New flashes of light in your vision
1 Better
2 Worse
3 Stayed about the same
4 I don't know
End of if
if nm001_order[cnt] = 2 and 2 in nm001 then
nm003b (better worse New spots in front of your eye ("floaters"))
New spots in front of your eye ("floaters")
1 Better
2 Worse
3 Stayed about the same
4 I don't know
End of if
if nm001_order[cnt] = 3 and 3 in nm001 then
nm003c (better worse New distortion of vision or blurry vision)
New distortion of vision or blurry vision
1 Better
2 Worse
3 Stayed about the same
4 I don't know
End of if
if nm001_order[cnt] = 4 and 4 in nm001 then
nm003d (better worse New darkening or graying out of vision )
New darkening or graying out of vision
1 Better
2 Worse
3 Stayed about the same
4 I don't know
End of if
if nm001_order[cnt] = 5 and 5 in nm001 then
nm003e (better worse New double vision)
New double vision
1 Better
2 Worse
3 Stayed about the same
4 I don't know
End of if
if nm001_order[cnt] = 6 and 6 in nm001 then
nm003f (better worse New glare or haloes)
New glare or haloes
1 Better
2 Worse
3 Stayed about the same
4 I don't know
End of if
if nm001_order[cnt] = 7 and 7 in nm001 then
nm003g (better worse New droopy eyelid)
New droopy eyelid
1 Better
2 Worse
3 Stayed about the same
4 I don't know
End of if
if nm001_order[cnt] = 8 and 8 in nm001 then
nm003h (better worse Other new symptom)
Other ([other new vision problems in last six months[]])
1 Better
2 Worse
3 Stayed about the same
4 I don't know
End of if
End of loop
End of subgroup of questions
End of group of questions
if iskeck = 1 then
Loop from 1 to 8
if (nm001_order[cnt] in nm001) then
nm004_order[cnt] := nm001_order[cnt]
Else
nm004_order[cnt] := empty
End of if
End of loop
if (sizeof(removeEmpties(nm004_order))) > 1 then
nm004 (which new vision problem currently bothering most)
Which of your new vision problems is currently bothering you the most?
1 New flashes of light in your vision
2 New spots in front of your eye (“floaters”)
3 New distortion of vision or blurry vision
4 New darkening or graying out of vision
5 New double vision
6 New glare or haloes
7 New droopy eyelid
8 Other ([other new vision problems in last six months[]])
Else
nm004 := reset(removeEmpties(nm004_order))
End of if
End of if
if (1 in nm001 and iskeck != 1) OR (nm004 = 1 and iskeck = 1) then
nm005 (new flashes of light in vision in one eye or both eyes at same time)
Are the new flashes of light in your vision in one eye or both eyes at the same time?
1 One eye occasionally
2 One eye constantly
3 Both eyes occasionally
4 Both eyes constantly
nm006 (see symmetrical heat waves in center part of vision that move outward)
Do you see symmetrical heat waves in the center part of your vision that move outward (scintillating scotoma) when you experience new flashes of light in your vision like the image below?
1 Yes
2 No
3 I don't know
nm007 (experience headache or migraine when experience new flashes of light in vision)
Do you also experience headache or migraine when you experience new flashes of light in your vision?
1 Yes
2 No
3 I don't know
End of if
if (3 in nm001 and iskeck != 1) OR (nm004 = 3 and iskeck = 1) then
nm008 ( new distortion or blurriness in vision improve with glasses or contact lenses)
Does the new distortion or blurriness in your vision improve with glasses or contact lenses?
1 Yes
2 No
3 I don't wear glasses or contacts
nm009 (dim, missing, or wavy lines when viewing Amsler grid)

Are there dim, missing, or wavy lines when viewing the Amsler grid?
1 Yes
2 No
3 I don't know
End of if
if (4 in nm001 and iskeck != 1) OR (nm004 = 4 and iskeck = 1) then
nm010 (how long each episode of darkening or graying out of vision last)
How long does each episode of the darkening or graying out of vision last?
1 Few seconds
2 A few minutes
3 Ten to 60 minutes
4 A few hours
5 Longer than 24 hours
6 I don't know
nm011 (darkening or graying in one eye or both eyes)
Is the darkening or graying in one eye or both eyes?
1 In one eye
2 In both eyes
3 I don't know
nm012 (have headache with each episode of darkening or graying out of vision)
Do you also have a headache with each episode of darkening or graying out of your vision?
1 Yes
2 No
3 I don't know
nm013 (pain when move eyes with each episode of darkening or graying out of vision)
Is there also pain when you move your eyes with each episode of darkening or graying out of your vision?
1 Yes
2 No
3 I don't know
End of if
if (5 in nm001 and iskeck != 1) OR (nm004 = 5 and iskeck = 1) then
nm014 (new double vision go away when close right eye)
Does your new double vision go away when you close your right eye?
1 Yes
2 No
3 I don't know
nm015 (new double vision go away when close left eye)
Does your new double vision go away when you close your left eye?
1 Yes
2 No
3 I don't know
End of if
if (7 in nm001 and iskeck != 1) OR (nm004 = 7 and iskeck = 1) then
nm016 (new droopy eyelid have double vision, headache, weakness, or neck pain)
Along with your new droopy eyelid, do you have double vision, headache, weakness, or neck pain?
1 Yes
2 No
3 I don't know
End of if
End of if
sectioncnt := 4
pn001 (any new eye pain in the last six months)
Have you noticed any new eye pain in the last six months (for example, burning, throbbing, itching, etc)?
1 Yes
2 No
3 I don't know
if pn001 = 1 then
pn002 (wear contact lenses)
Do you wear contact lenses?
1 (YES) Yes
2 (NO) No
pn003 (had trauma to the eye or eyelid)
Over the last month, have you had trauma to the eye or eyelid (for example being struck in the eye while playing a sport)?
1 Yes
2 No
3 I don't know
pn004 (something gotten into eye)
Has something gotten into your eye?
1 Yes
2 No
3 I don't know
pn005 (vision gotten worse since started experiencing new eye pain)
Has your vision gotten worse since you started experiencing new eye pain?
1 Yes
2 No
3 I don't know
pn006 (eye pain improve after using artificial tears)
Does your eye pain improve after using artificial tears?
1 Yes
2 No
3 I don't know
pn007 (when did eye pain start)
When did your eye pain start?
1 Within the last day
2 Within the last week
3 Within the last month
4 More than one month ago
5 I don't know
pn008 (how often eye pain occur)
How often does your eye pain occur?
1 Constantly
2 Several times per day
3 Several times per week
4 Several times per month
5 Less than once per month, but several times over the last 6 months
6 Once or twice in the last 6 months
7 I don't know
pn009 (new eye pain getting better, worse, or about the same)
Over the last month, is your new eye pain getting better, worse, or about the same?
1 Getting better
2 Getting worse
3 About the same
if sizeof(pn010_order) = 0 then
pn010_order := shuffleArray(array(1 => 1, 2 => 2, 3 => 3, 4 => 4, 5 => 5, 6 => 6))
pn010_order[7] := 7
pn010_order[8] := 8
End of if
Group of questions presented on the same screen
pn010 (describe new eye pain)
How would you describe your new eye pain? (please check all that apply)
1 Burning
2 Itching
3 Dull, achy, throbbing pain
4 Scratchy, like there is something in your eye
5 Sensitivity to light
6 Pain around the eyeball socket
7 Other, please specify:
8 I don't know
pn010_other (other describe new eye pain)
STRING
End of group of questions
if 1 in pn010 or 2 in pn010 or 4 in pn010 then
pn011 (with new eye pain, also have cold or flu symptoms)
Along with your new eye pain, do you also have cold or flu symptoms (e.g., sore throat, runny nose)?
1 Yes
2 No
3 I don't know
pn012 (have seasonal allergies)
Do you have seasonal allergies?
1 Yes
2 No
3 I don't know
pn013 (taking blood thinners and have developed a new red patch on the white part of eye)
Are you taking blood thinners and have developed a new red patch on the white part of your eye?
1 Yes
2 No
3 I don't know
End of if
if 3 in pn010 then
pn014 (eye pain occur when concentrating on something at arms length reading distance or closer)
Does your eye pain occur when concentrating on something at arm's length reading distance or closer?
1 Yes
2 No
3 I don't know
pn015 (eye pain occur along with blurred vision when use any medications)
Does the eye pain occur along with blurred vision when you use any of the following medications?
  • Diphenhydramine [Benadryl], promethazine [Phenergan], or other antihistamines
  • Tropicamide, phenylephrine, or pilocarpine eye drops
  • Ipratropium [Atrovent] or other asthma inhaler
  • Botulinum Toxin [Botox] injection around the eye
  • Imipramine [Tofranil], amitriptyline [Elavil], or other tricyclic antidepressants (TCAs)
  • Fluoxetine [Prozac] or other selective serotonin reuptake inhibitors (SSRIs)
  • Fluphenazine [Modecate] or other antipsychotics
  • Oxymetazoline [Afrin] or other nasal decongestant sprays
  • Topiramate [Topamax], acetazolamide [Diamox], or other sulfa-based drugs
  • Heparin
  • Ephedrine, epinephrine, or amphetamines (ie MDMA, cocaine)
1 Yes
2 No
3 I don't use any of these medications
4 I don't know
End of if
if 6 in pn010 then
pn016 (have sinus symptoms like congestion and stuffy nose or chronic sinus disease)
Along with the pain around your eye socket, do you have sinus symptoms like congestion and stuffy nose or chronic sinus disease?
1 Yes
2 No
3 I don't know
End of if
End of if
pn017 (noticed feeling as if you are constantly tearing)
In the last six months, have you noticed feeling as if you are constantly tearing?
1 Yes
2 No
3 I don't know
sectioncnt := 5
if iskeck = 1 then
ba001 (how many eye care providers in past two years)
In the past two years, how many eye care providers (for example, ophthalmologists or optometrists) have you seen?
1 I have never seen an eye care provider before today
2 1
3 2
4 3
5 4+
Group of questions presented on the same screen
ba002 (referred)
Did anyone refer you here?
1 Yes. Who was this:
2 No
ba002_who (who referred)
STRING
End of group of questions
Group of questions presented on the same screen
ba003 (problems making appointment)
Did you experience any problems scheduling this appointment?
1 Yes. Please specify:
2 No
ba003_problem (what problems)
STRING
End of group of questions
ba004 (how confident seeing right provider today for problem)
How confident are you that you are seeing the right provider today for your problem?
1 Very confident
2 Somewhat confident
3 Unsure
4 Somewhat confident
5 Very confident
ba005 (age)
What is your age?
RANGE 18..120
ba006 (highest education)
What is the highest grade or level of school you have completed or the highest degree you have received?
1 Less than 1st grade
2 Up to 4th grade
3 5th or 6th grade
4 7th or 8th grade
5 9th grade
6 10th grade
7 11th grade
8 12th grade-no diploma
9 High school graduate or GED
10 Some college-no degree
11 Assoc. college degree-occ/voc program
12 Assoc. college degree-academic program
13 Bachelor's degree
14 Master's degree
15 Professional school degree
16 Doctorate degree
Group of questions presented on the same screen
ba007 (work status)
What is your labor force status? Please choose all that apply.
1 Currently working
2 On sick or other leave
3 Unemployed - on layoff
4 Unemployed - looking
5 Retired
6 Disabled
7 Keeping house
8 Student
9 Other, please specify:
ba007_other (other work status)
STRING
End of group of questions
ba008 (annual household income)
Which category represents the total combined income of all members of your family living in your house) during the past 12 months? This includes money from jobs, net income from business, farm or rent, pensions, dividends, interest, Social Security payments and any other monetary income received by members of your family who are 15 years of age or older.
1 Less than $5,000
2 5,000 to 7,499
3 7,500 to 9,999
4 10,000 to 12,499
5 12,500 to 14,999
6 15,000 to 19,999
7 20,000 to 24,999
8 25,000 to 29,999
9 30,000 to 34,999
10 35,000 to 39,999
11 40,000 to 49,999
12 50,000 to 59,999
13 60,000 to 74,999
14 75,000 to 99,999
15 100,000 to 149,999
16 150,000 or more
End of if
sectioncnt := 6
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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