Attachment 3 Source Table for Survey Items 2012

Question # wave 3	Question	Source	Prior OMB Approval
1	Are you currently attending high school, vocational school, or college? If YES, please indicate which type of school and the name of the school.	Pilot tested in 2012
2	What is the most schooling you think you will complete?	Pilot tested in 2012
3	On average, during the school year,. How many hours per week do you work in paid or unpaid jobs?	Monitoring the future. Bachman, J. (1983). Premature affluence: Do high school students earn too much. Economic Outlook, 10(3), 64-67
4	How much spending money do you have during an average month?	Larimer, M., & Neighbors, C. Normative misperception and the impact of descriptive and injunctive norms on college student gambling. Psychology of Addictive Behaviors, Vol 17(3), Sep 2003, 235-243.
5	About how many hours a day do you usually play games on a computer or games console (Playstation, Xbox, Gamecube etc.) in your free time?	HBSC 2002, 2006, 2010 (expanded computer use question to include computer game use).	HBSC 2005/2006 (OMB #0925/-0557), HBSC 2009/2010 (OMB# 0925-0557)
6	Do you have a computer, games console, or television in the room where you sleep?	Cited in other articles as "adapted from HBSC"
7	About how many hours a day do you usually use a computer or cell phone for chatting on-line, internet, emailing, tweeting or something similar other than school work during your free time?	HBSC 1990, 1994, 1998, 2002, 2006, 2010 (revised:weekly activity changed to daily; weekday/weeekend split introduced; definition in brackets added)	HSBC 1997/98 (OMB #0925-0451) HSBC 2001/02 (OMB #0915-0254) HSBC 2005/06 (OMB #0925-0557), HBSC 2009/2010 (OMB# 0925-0557)
8	About how many hours a day do you usually use a DVD player or watch television (including videos and DVDs) in your free time?	HBSC surveys 1985/86, 1989/90, 1993/94, 1997/98, 2001/02, 2005/06, 2009/10 (Revised: weekday/weekend split introduced; response categories expanded; 'videos' included)	HSBC 1997/98 (OMB #0925-0451) HSBC 2001/02 (OMB #0915-0254) HSBC 2005/06 (OMB #0925-0557), HBSC 2009/2010 (OMB# 0925-0557)
9	The amount of free time I spend watching TV and videos, playing video games, and using computers is because:	Adapted from Ryan, R. M., & Connell, J. P. (1989). Perceived locus of causality and internalization: Examining reasons for acting in two domains. Journal of Personality and Social Psychology, 57, 749-761.
10a	Please answer this question for the home where you live all or most of the time and check all the people who live there.	Adapted from 2001/02 HBSC survey, HBSC 2005/06, 2009/10	HBSC 2005/06 (OMB #0925-0557), HBSC 2009/2010 (OMB# 0925-0557)
10b	Do you have any children of your own (including step-children or adopted children)?	Pilot tested in 2012
11	If you are female, are you currently pregnant or breastfeeding? (SKIP THIS QUESTION if you are male)	Pilot tested in 2012
12	At this time, do you feel you are…?	Childrens Body Image Scale (CBIS); HBSC surveys 1993/94, 1997/98, 2001/02, 2005/06, 2009/10	HBSC 1997/98 (OMB #0925-0451) HBSC 2001/02 (OMB #0915-0254) HBSC 2005/06 (OMB #0925-0557), HBSC 2009/2010 (OMB# 0925-0557)
13	Over the past 7 days, on how many days were you physically active for a total of at least 60 minutes per day?	Adapted for use in HBSC survey 2001/02, 2005/06, 2009/10….Prochaska JJ, Sallis JF, Long B. (2001). A physical activity screening measure for use with adolescents in primary care. Archives of Paediatrics & Adolescent Medicine. 155: 554-559.	HBSC 2001/02 (OMB #0915-0254) HBSC 2005/06 (OMB #0925-0557), HBSC 2009/2010 (OMB# 0925-0557)
14	How many HOURS a week do you usually engage in vigorous physical activity so much that you get out of breath or sweat?	HBSC surveys 1985/86, 1989/90, 1993/94, 1997/98, 2001/02 (optional) 2005/06, 2009/10	HBSC 1997/98 (OMB #0925-0451) HBSC 2001/02 (OMB #0915-0254) HBSC 2005/06 (OMB #0925-0557), HBSC 2009/2010 (OMB# 0925-0557)
15	Think about the last seven days. How often did you do each of the these when making plans for vigorous physical activity?	Luszczynska, A. (2006). Effects of an implementation intention intervention on physical activity after MI are mediated by cognitive processes, change in forming action plans. Social Science and Medicine, 62, 900–908; Adapted from Dombrowski & Luszczynska Applied Psychology 2009; 58:257-273
16a	During the pasdt 12 months, how many individual sports did you participate in on a competitive level, sduch as varsity or junior varsity sports, intramurals, sports clubs or leagues, or out-of-school programs?	2009 national high school YRBS questionnaire
16b	If one or more, what competitive sports did y ou participate in?	2009 national high school YRBS questionnaire
17	How long does it usually take you to travel to school from your home?	Adapted from 1985/86 HBSC optional package and EYHS (Riddoch et al)(2005). The European Youth Hearth Study Cardiovascular Disease Factors in Children: Rationale, Aims, Study Design, and Validation of Methods. Journal of Physical Activity and Health , 2(1), 115-129). HBSC 2009/10	HBSC 2009/2010 (OMB# 0925-0557)
18	On a typical day is the MAIN part of your journey TO school made by…?	Adapted from 1985/86 HBSC optional package and EYHS (Riddoch et al)(2005). The European Youth Hearth Study Cardiovascular Disease Factors in Children: Rationale, Aims, Study Design, and Validation of Methods. Journal of Physical Activity and Health , 2(1). HBSC 2009/10	HBSC 2009/2010 (OMB# 0925-0557)
	On a typical day is the MAIN part of your journey FROM school made by…?	Adapted from 1985/86 HBSC optional package and EYHS (Riddoch et al)(2005). The European Youth Hearth Study Cardiovascular Disease Factors in Children: Rationale, Aims, Study Design, and Validation of Methods. Journal of Physical Activity and Health , 2(1). HBSC 2009/10	HBSC 2009/2010 (OMB# 0925-0557)
19	When I am physically active for at least one hour it is because:	Adapted from Ryan, R. M., & Connell, J. P. (1989). Perceived locus of causality and internalization: Examining reasons for acting in two domains. Journal of Personality and Social Psychology, 57, 749-761.
20	On days that you go to school, work, or similar activities, what time do you usually wake up?	National Longitudinal Study of Adolescent Health (Add Health)
21	On days that you don't have to get up at a certain time, what time do you usually wake up?	National Longitudinal Study of Adolescent Health (Add Health)
22	Over the past four weeks: How often did you have trouble falling asleep? How often did you have staying asleep through the nights? For example, you woke up several times at night or woke up earlier than you planned to?	National Longitudinal Study of Adolescent Health (Add Health)
23	Based on what you have noticed or what others have told you, are there times when you snore or you stop breathing during your sleep?	National Longitudinal Study of Adolescent Health (Add Health)
24	How often do you usually have breakfast (more than a glass of milk or fruit juice)?	HBSC survey 2002, 2006, 2010	HBSC 2001/02 (OMB #0915-0254) HBSC 2005/06 (OMB #0925-0557), HBSC 2009/2010 (OMB# 0925-0557)
25	During the past 7 days, how many times did you:	Youth Risk Behavior Survey	YRBS (OMB# 0920-0493)
26	I eat the way I do most days because:	Adapted from Ryan, R. M., & Connell, J. P. (1989). Perceived locus of causality and internalization: Examining reasons for acting in two domains. Journal of Personality and Social Psychology, 57, 749-761.
27a	How often do you have breakfast together with your mother (or stepmother) or father (or stepfather)?	HBSC 2009/2010	HBSC 2009/2010 (OMB# 0925-0557)
27b	How often do you have an evening meal together with your mother (or stepmother) or father (or stepfather)?	HBSC 2009/2010	HBSC 2009/2010 (OMB# 0925-0557)
27c	How often do you watch television during a meal at home?	HBSC 2009/2010	HBSC 2009/2010 (OMB# 0925-0557)
27d	How often do you have a meal with friends outside of school?	HBSC 2009/2010	HBSC 2009/2010 (OMB# 0925-0557)
28	Where do you usually eat your mid-day meal on schooldays?	Flemish HBSC 1996, 1998 HBSC Survey 2009/10	HBSC 2009/2010 (OMB# 0925-0557)
29	How often do you eat in a fast food restaurant (for example, McDonalds, KFC, Pizza Hut, Taco Bell)?	HBSC (optional) 2001/02, 2005/06, 2009/10	HBSC 2005/06 (OMB #0925-0557), HBSC 2009/2010 (OMB# 0925-0557)
30	How much do you weigh without clothes?	HBSC surveys 1997/98 (optional package), 2001/02 (mandatory), 2005/06, 2009/10	HBSC 1997/98 (OMB #0925-0451) HBSC 2001/02 (OMB #0915-0254) HBSC 2005/06 (OMB #0925-0557), HBSC 2009/2010 (OMB# 0925-0557)
31	How tall are you without shoes?	HBSC surveys 1997/98 (optional package), 2001/02 (mandatory), 2005/06, 2009/10	HBSC 1997/98 (OMB #0925-0451) HBSC 2001/02 (OMB #0915-0254) HBSC 2005/06 (OMB #0925-0557), HBSC 2009/2010 (OMB# 0925-0557)
32	Have you heard about (or are you aware of): My pyramid; Dietary Guidelines of Americans; My Plate	Adapted from NHANES 2005-06 survey
33	At present are you on a diet or doing something else to lose weight?	HBSC surveys 1993/94, 1997/98, 2001/02 (revised: definition was expanded to include 'doing something else'; response category 3 was added), 2005/06, 2009/10	HBSC 1997/98 (OMB #0925-0451) HBSC 2001/02 (OMB #0915-0254) HBSC 2005/06 (OMB #0925-0557), HBSC 2009/2010 (OMB# 0925-0557)
34	I am doing something to lose weight becase:	Adapted from Ryan, R. M., & Connell, J. P. (1989). Perceived locus of causality and internalization: Examining reasons for acting in two domains. Journal of Personality and Social Psychology, 57, 749-761.
35	Would you say your health is…?	Idler, E.L. & Benjamin, Y. (1997). Self-rated health and mortality: A review of twenty-seven community studies. Journal of Health and Social Behavior, 38, 21-37. HBSC 2002, 2006, 2010	HBSC 2001/02 (OMB #0915-0254) HBSC 2005/06 (OMB# 0925-0557), HBSC 2009/2010 (OMB# 0925-0557)
36	How often do you brush your teeth?	HBSC surveys 1985/86, 1989/90, 1993/94, 1997/98, 2001/02, 2005/06, 2009/10	HBSC 1997/98 (OMB #0925-0451) HBSC 2001/02 (OMB #0915-0254) HBSC 2005/06 (OMB #0925-0557), HBSC 2009/2010 (OMB# 0925-0557)
37	In the last 6 months: how often have you had the following..?	HBSC 2002, 2006, 2010	HBSC 1997/98 (OMB #0925-0451) HBSC 2001/02 (OMB #0915-0254) HBSC 2005/06 (OMB #0925-0557), HBSC 2009/2010 (OMB# 0925-0557)
38	During the last month have you taken any medicine of tablets for the following?	U.S. HBSC survey 2001/02, 2005/06 (added "something else"), 2009/10	HBSC 2001/02 (OMB #0915-0254) HBSC 2005-06 (OMB #0925-0557), HBSC 2009/2010 (OMB# 0925-0557)
39	Do you have a long-term illness, disability, or medical condition(like diabetes, arthritis, asthma, allergy, or celebral palsy) that has been diagnosed by a doctor?	Optional Item used in International HBSC 2005/06 (adapted from Finnish Canadian HBSC 2001/02 national surveys), 2009/10	HBSC 2009/2010 (OMB# 0925-0557)
40	Do you take medicine for your long-term illness, disability, or medical condition	Optional Item used in International HBSC 2005/06 (adapted from Finnish Canadian HBSC 2001/02 national surveys), 2009/10	HBSC 2009/2010 (OMB# 0925-0557)
41	Does your long-term illness, disability or medical condition affect your attendance and participation at school?	Optional Item used in International HBSC 2005/06 (adapted from Finnish Canadian HBSC 2001/02 national surveys), 2009/10	HBSC 2009/2010 (OMB# 0925-0557)
42	Think about how you have been feeling over the last 30 days.	PROMIS pediatric depressive symptoms scale Irwin, D., Stucky, B., Langer, M., Thissen, D., et al. (2010) An item response analysis of the pediatric PROMIZ anxiety and depressive symptoms scale. Quality of life, 19(4), 595-607
43	How much does your mother (or female guardian) really know about...?	Rispens, J., Hermanns, J.M.A., & Meeus, W.H.J. (Eds.) (1997). Opvoeden in Nederland [Parenting in the Netherlands]. Assen: van Gorcum; HBSC 2002, 2006 (optional package), 2010.	HBSC 2001/02 (OMB #0915-0254) HBSC 2005/06 (OMB# 0925-0557), HBSC 2009/2010 (OMB# 0925-0557)
44	How much does your father (or male guardian) really know about..?	Rispens, J., Hermanns, J.M.A., & Meeus, W.H.J. (Eds.) (1997). Opvoeden in Nederland [Parenting in the Netherlands]. Assen: van Gorcum; HBSC 2002, 2006 (optional package), 2010.	HBSC 2001/02 (OMB #0915-0254) HBSC 2005/06 (OMB# 0925-0557), HBSC 2009/2010 (OMB# 0925-0557)
45	In general, how satisfied are you with the relationships in your family?	HBSC 2002, 2006
46	How important is it to your parent/guardian that you…	Adapted from the National Survey on Drug Use and Health	NSDUH (OMB# 0930-0110)
47	Your group of friends is well accepted by your parents?	HBSC 2002 Revised, 2006, 2010	HBSC 2001/02 (OMB #0915-0254) HBSC 2005/06 (OMB# 0925-0557), HBSC 2009/2010 (OMB# 0925-0557)
48	Think of your closest male friends. List up to five of your closest male friends. List your best male friend first, then next best friend, and so on. Include boys who are friends and boyfriends.	National Longitudinal Study of Adolescent Health (Add Health)
49	Think of your closest female friends. List up to five of your closest female friends. List your best female friend first, then next best friend, and so on. Include girls who are friends and girlfriends.	National Longitudinal Study of Adolescent Health (Add Health)
50	Think of your closest male friend, your closest female friend, your 5 closest friends, and the general group of friends and classmates that you spend time with.	National Longitudinal Study of Adolescent Health (Add Health)
51a	In the past couple of months, how often have you been bullied at school or work using a computer, e-mail messages or pictures?	Condensed version of cyber q’s used in HBSC 2005 Used in HBSC 2005: Modified from Olweus Bully/Victim Questionnaire.
51b	In the past couple of months, how often have you been bullied at school or work using a cell phone?
51c	In the past couple of months, how often have you bullied another student(s) or co-worker at school or work using a computer, e-mail messages or pictures?
51d	In the past couple of months, how often have you bullied another student(s) or co-worker at school or work using a cell phone?
52	Which of the following best describes your sexual orientation?	Seattle Teen Health Risk Survey 1995 (SEA95)
53	In the last 12 months, have you had a romantic relationship with anyone?	Modified from Add Health: (Add Health uses past 18 months instead of past 12 months)
54a & 54c	Part 1: info about partner; general relationshp info; happiness; importance	Happiness-- Adapted from :Locke, H. J. (1951). Predicting adjustment in marriage: A comparison of a divorced and a happily married group. New York: Holt.
	Part 2: Pyschological- vic/perp: During the last 12 months: Threat; not let me do with other people; insulted infront of others; hurt my feelings on purpose; said mean things to me to make me feel bad	Revised Conflict tactics scale: Straus, M. A., Hamby, S. L., Boney McCoy, S., & Sugarman, D. B. (1996). The revised Conflict Tactics Scales (CTS2): Development and preliminary psychometric data. Journal of Family Issues, 17, 283– 316. Foshee, V., Bauman, K., Arriaga, X., Helms, R., Koch, G., & Linder, F. (1998). An evaluation of Safe Dates, an adolescent dating violence prevention program. American Journal of Public health, 88(1). Wolfe, D., Scott, K., Reitzel-Jaffe, D., Wekerle, C., Grasley, C., & Straatman, A. (2001). Development and Validation of the Conflict in Adolescent Dating Relationships Inventory. Psychological Assessment, 13(2), 277-293
	Part 3: Physical- vic/perp: During the last 12 months: Slapped or scratched me; physically twisted my arm or bent my fingers; pushed, grabbed, shoved, or kicked me; hit me with a fist or something else hard; assulted me with a knife or gun
	Part 4: Sexual- vic/perp: During the last 12 months: kissed when did not want to be kissed; showed naked pictures; show private parts when did not want to see; put hands on private parts when did not want to; forced sex
	Part 5: cyber - vic/perp: During the last 12 months, using the following technologies: spread rumors; call names or said something mean; showed private or embarressing pictures; repeatedly checked up to see eachothers where abouts	Adapted from: PICARD,P (2007). TEEN RESEARCH UNLIMITED, TECH ABUSE IN TEEN RELATIONSHIPS STUDY (prepared for Liz Claiborne, Inc.) Website: http://www.loveisrespect.org/wp-content/uploads/2009/03/liz-claiborne-2007-tech-relationship-abuse.pdf
54b & 54d	Has this person hit you out of self-defense? Consequences of self defense: injured, bruised, cut, burn, broken bone. Consequences of self defense: having to see a nurse or doctor	Foshee, V., Bauman, K., Arriaga, X., Helms, R., Koch, G., & Linder, F. (1998). An evaluation of Safe Dates, an adolescent dating violence prevention program. American Journal of Public health, 88(1).
55	I treat my partner the way I do because:	Adapted from Ryan, R. M., & Connell, J. P. (1989). Perceived locus of causality and internalization: Examining reasons for acting in two domains. Journal of Personality and Social Psychology, 57, 749-761.
56	At present, how often do you drink anything alcoholic, such as beer, wine or hard liquor like, Vodka or rum? Throughout these questions, by a "drink," we mean a can or bottle of beer, a glass of wine or wine cooler, a shot of liquor, or a mixed drink with liquor in it.	HSBC 1986, 1990, 1994, 1998, 2002, 2010	HBSC 2009/2010 (OMB# 0925-0557)
57	Think about the first time you had a drink of an alcoholic beverage. How old were you the first drink you had a drink of an alcoholic beverage?	HSBC 1998, 2002, 2005, 2010	HBSC 2009/2010 (OMB# 0925-0557)
58	On how many occasions (if any) have you done the following things in the last 30 days?	ESPAD, HBSC 2005/06, 2009/10	HBSC 2005/06 (OMB #0925-0557), HBSC 2009/2010 (OMB# 0925-0557)
59	Think back again over the LAST 30 DAYS. If you are a boy, how many times (if any) have you had five or more drinks in a row on an occasion? If you are a girl, how many times (if any) have you had four or more drinks in a row on an occasion.	Youth Risk Behavior Survey	YRBS (OMB# 0920-0493)
60	Thin back again over the LAST 30 DAYS. If you are a boy, how many times (if any) have you had five or more drinks in a row within two hours? If you are a girl, how many times (if any) have you had four or more drinks in a row within 2 hours?	Youth Risk Behavior Survey	YRBS (OMB# 0920-0493)
61	Think of the last time you drank alcohol. Where were you when you drank?	ESPAD (European School Survey Project on Alcohol & other Drugs
62	I decide whether or not to smoke tobacco, drink alcohol, or smoke marijana because:	Adapted from Ryan, R. M., & Connell, J. P. (1989). Perceived locus of causality and internalization: Examining reasons for acting in two domains. Journal of Personality and Social Psychology, 57, 749-761.
63	Have you ever taken on or several of these drugs in the last 12 months?	HBSC 2002, 2006, 2010	HSBC 2001/02 (OMB #0915-0254) HSBC 2005/06 (OMB #0925-0557)
64	Do you have a drivers license?	Checkpoints	Checkpoints (OMB # 0925-0577; Expiration Date: 01/31/2010)
65	How much of the time during the past 30 days have you had access to a vehicle?	Checkpoints	Checkpoints (OMB # 0925-0577; Expiration Date: 01/31/2010)
66	On how many of last 30 days did you drive a vehicle?	Checkpoints	Checkpoints (OMB # 0925-0577; Expiration Date: 01/31/2010)
67	On average, about how many miles did you drive each day you drove?	Checkpoints	Checkpoints (OMB # 0925-0577; Expiration Date: 01/31/2010)
68	On how many days in the past month have you driven with 2 or more passengers in the vehicle?	Checkpoints	Checkpoints (OMB # 0925-0577; Expiration Date: 01/31/2010)
69	On how many days in the past 30 days have you done the following while driving?	Checkpoints	Checkpoints (OMB # 0925-0577; Expiration Date: 01/31/2010)
69a	Answered a phone call on your cell phone
69b	Made a call on your cell phone
69c	changed radio station
69d	Changed music on MP3, CD, or other device
69e	Read text messages
69f	Sent text messages
69g	Drank or eaten
69h	Used a navigation system
69i	Looked a maps or directions while driving
70	On how many days in the past month have you done the following while driving?	Checkpoints	Checkpoints (OMB # 0925-0577; Expiration Date: 01/31/2010)
71	How often in the last 12 months have you driven a vehicle (motorcycle, car, truck, or SUV) in a street race?
72	The last time you were a driver in a street race, how many passengers were in your vehicle?
73	How often do you wear a seat belt when riding in a vehicle driven by someone else?	Checkpoints	Checkpoints (OMB # 0925-0577; Expiration Date: 01/31/2010)
74	During the past year, how many times did you ride in a car or other vehicle driven by someone else who had been drinking alcohol or using illegal drugs?	Youth Risk Behavior Survey	YRBS (OMB# 0920-0493)
75	How often in the last 12 months have you been a passenger in a vehicle in a street race?	Pilot tested in 2012
76	In the last year, have you been in a motor vehicle accident?	Youth Risk Behavior Survey	YRBS (OMB# 0920-0493)
77	Which of the following best describes your current health insurance situation?	National Longitudinal Study of Adolescent Health (Add Health)
78	Where do you usually go when you are sick or need health care?	National Longitudinal Study of Adolescent Health (Add Health)
79	Has there been any time in the past 12 months when you thought you should get medical care, but you did not?	National Longitudinal Study of Adolescent Health (Add Health)
80	What kept you from seeing a health professional when you really needed to?	National Longitudinal Study of Adolescent Health (Add Health)
81	In the past 12 months, did a health problem get worse because you did not get care when you thought you should have?	National Longitudinal Study of Adolescent Health (Add Health)
82	How long ago did you last have a rountine check up?	National Longitudinal Study of Adolescent Health (Add Health)
83	At your last physical examination by a doctor or nurse?	National Longitudinal Study of Adolescent Health (Add Health)
84	In the past 12 months have you had a dental examination by a dentist or dental hygienist?	National Longitudinal Study of Adolescent Health (Add Health)
85	What do you think are the changes that you will live to age 35?	EAT survey Idler, E.L. & Benjamin, Y. (1997). Self-rated health and mortality: A review of twenty-seven community studies. Journal of Health and Social Behavior, 38, 21-37. HBSC 2002, 2006, 2010