Attachment A - R74 PVQ (Sept 2015)

Preventive Care (PVQ)
Variable Name
MR Screen Name Question type Question text/description
IF RESPONDENT IS DECEASED, GO TO BOX PVEND.
ELSE IF (SEASON=SUMMER) AND (WINTER ROUND RESONSE TO PVF1BOX PVBEG
routing
FLUSHOT=1/YES) GO TO BOX PVEND.
ELSE GO TO PVINT-PVINTRO.
IF SEASON=WINTER FILL "Now I’d like to ask you some questions about the
seasonal flu vaccine."
PVINTRO
PVINT
No entry
ELSE IF SEASON=SUMMER, FILL "Last time we interviewed you, you told us that
you had not gotten a flu vaccination for the [CURRENT YEAR MINUS 1] [CURRENT YEAR] flu season."

FLUSHOT

PVF1

BOX PV1

yes/no

routing

PVF2

code all

FLUOTHOS

PVF2

verbatim text

BOX PV2

routing

PVFLU3

NOVACINE

Routing

[July 1st, (CURRENT YEAR MINUS
1)] SEASON=WINTER
[MREFDATE] SEASON=SUMMER
[have you] respondent is SP
[has (SP)] respondent is proxy

(01) PVF5-VACSUPLY
(02) BOX PV1
(-8) BOX PVEND
(-9) BOX PVEND

IF SEASON=WINTER GO TO PVF2-FLUCODE.
ELSE GO TO BOX PVEND.

[PROBE: Any other reason?]
CHECK ALL THAT APPLY.

(01) DIDN’T KNOW IT WAS NEEDED
(02) SHOT COULD CAUSE FLU
(03) SHOT COULD HAVE SIDE EFFECTS OR CAUSE DISEASE
(04) DIDN’T THINK IT WOULD PREVENT THE FLU/COULD GET THE FLU
ANYWAY
(05) FLU NOT SERIOUS/WOULD NOT GET FLU ANYWAY/NOT AT
RISK/NEVER GET THE FLU
(06) DOCTOR DID NOT RECOMMEND THE SHOT
(07) DOCTOR RECOMMENDED AGAINST GETTING VACCINE
(08) DON'T LIKE SHOTS OR NEEDLES/CONCERNS ABOUT SORENESS OR
RASH/LOCAL REACTIONS
(09) INCONVENIENT TO GET SHOT/UNABLE TO GET TO LOCATION
[you] respondent is SP
(10) DIDN’T THINK ABOUT IT/FORGOT/MISSED IT
[(SP)] respondent is proxy
(11) COST OF VACCINE
(12) HAD VACCINE BEFORE/DIDN’T NEED IT AGAIN
(13) VACCINE UNAVAILABLE/VACCINE SHORTAGE
(14) NOT WORTH THE MONEY
(15) DIDN'T HAVE TIME
(16) NOT IN HIGH RISK/PRIORITY GROUP
(17) ONGOING HEALTH CONDITION PREVENTING VACCINE/ALLERGIC
TO SHOT/MEDICAL REASONS
(18) DON'T TRUST WHAT GOVERNMENT SAYS ABOUT VACCINE
(91) OTHER
(-8) DON'T KNOW
(-9) REFUSED

OTHER (SPECIFY)
IF MORE THAN ONE RESPONSE SELECTED AS YES AT PVF2-FLUCODE, GO TO PVF3PVFLU3, ELSE GO TO BOX PV3
Of the reasons you listed, what is the main reason [you/(SP)] did not get a flu
vaccination this flu season?

(01) BOX PV2
(02) BOX PV2
(03) BOX PV2
(04) BOX PV2
(05) BOX PV2
(06) BOX PV2
(07) BOX PV2
(08) BOX PV2
(09) BOX PV2
(10) BOX PV2
(11) BOX PV2
(12) BOX PV2
(13) BOX PV2
(14) BOX PV2
(15) BOX PV2
(16) BOX PV2
(17) BOX PV2
(18) BOX PV2
(91) PVF2 - FLUOTHOS
(-8) BOX PV2
(-9) BOX PV2

BOX PV2

PVF3

code 1

[LIST ALL RESPONSES SELECTED AT PVF2-FLUCODE]
_ _ [ENTER MAIN REASON]
READ LIST TO RESPONDENT. IF RESPONDENT SELECTS MORE THAN ONE REASON
(-8) DON’T KNOW
PROBE FOR MAIN REASON.
(-9) REFUSED

BOX PV3

routing

IF RESPONSE TO PVF2-FLUCODE DOES NOT INCLUDE 13, GO TO PVF4-NOVACINE.
ELSE GO TO BOX PVEND.

yes/no

Was one reason that [you/(SP)] did not get a seasonal flu vaccination since July
1st, [CURRENT YEAR MINUS 1] because the vaccine was in short supply or
unavailable?

PVF4

Text Fill Logic

PVF1-FLUSHOT

Since [July 1st, (CURRENT YEAR MINUS 1)/[MREFDATE]], [have you/has (SP)] had
(01) YES
a seasonal flu vaccination?
(02) NO
(-8) DON’T KNOW
IF THE RESPONDENT MENTIONS A SHORT NEEDLE OR NEEDLELESS INJECTOR,
(-9) REFUSED
CODE AS “YES”.

For what reason didn't [you/(SP)] get a seasonal flu vaccination since July 1st?
FLUCODE

Code list

(01) YES
(02) NO
(-8) DON'T KNOW
(-9) REFUSED

[you] respondent is SP
[(SP)] respondent is proxy

BOX PV3

[you] respondent is SP
[(SP)] respondent is proxy

BOX PVEND

VACSUPLY

PVF5

yes/no

Did [you/(SP)] have any trouble getting a seasonal flu shot when (you/he/she)
wanted to because the vaccine was in short supply or unavailable?

BOX PVEND

routing

GO TO NEXT SECTION.

(01) YES
(02) NO
(-8) DON'T KNOW
(-9) REFUSED

[you] respondent is SP
[(SP)] respondent is proxy
[you] respondent is SP
BOX PVEND
[he] respondent is proxy, SP male
[she] respondent is proxy, SP
female