No Number National Inmate Survey Year 3 Alt

National Inmate Survey (NIS)

Revised_B_NIS_AltQuestionniare (2)

National Inmate Survey, 2010

OMB: 1121-0311

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National Inmate Survey: Year 3

Questionnaire Specifications for 10% Sample

DRAFT: 3/19/10



A1 TYPE OF INTERVIEW:

  1. ENGLISH MALE

  2. ENGLISH FEMALE

  3. SPANISH MALE

  4. SPANISH FEMALE


TIME STAMP HERE


INTRO As I mentioned before, the National Inmate Survey is a research study being done by the Bureau of Justice Statistics and RTI International, a not-for-profit research organization in North Carolina.


This interview will take about 35 minutes. Your name will never be connected with the information you provide in this interview. We will treat everything you say as private and confidential. We will not share any information you provide with anyone outside or at the facility or anyone who is not working on the project.


OMB INTERVIEWER: IF RESPONDENT ASKS ANY QUESTIONS ABOUT OMB APPROVAL FOR THIS STUDY, YOU MAY READ THE INFORMATION BELOW. OTHERWISE TOUCH THE NEXT BUTTON TO GO TO THE NEXT SCREEN.


Notice: Public reporting for this collection of information is estimated to average 30 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Director, Bureau of Justice Statistics, 810 Seventh Street, NW, Washington, DC 20531. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. The OMB control number for this project is 1121-0311.


I1 FACILITY ID


____________________



I2 ENTER YOUR INTERVIEWER ID NUMBER:


__________ [ALLOW 6 DIGITS]


I3 IS AN INCENTIVE BEING OFFERED TO INMATES AT THIS FACILITY?


  1. YES

  2. NO


Section A – Demographics (CAPI)


TIME STAMP HERE


The first few questions are for statistical purposes only, to help us analyze the results of the study.

A2 In what year were you born?


4-DIGIT YEAR: _________

DK/REF


DEFINE CALCAGE:

CALCAGE = AGE CALCULATED BY SUBTRACTING A2 YEAR FROM CURRENT YEAR.


A3 [IF A2 NE (DK OR REF)] Are you CALCAGE – 1 or CALCAGE?


1 CALCAGE – 1

2 CALCAGE

DK/REF


NOTE TO PROGRAMMER: The actual age should be written to the file in addition to the respondent’s actual answer to A3.


A4 [IF (A2=DK OR REF) OR A3 = DK OR REF] How old are you?


AGE: ____________

DK/REF


NOTE: IF A4 NE BLANK, THEN REDEFINE CALCAGE = A4


I4 [IF CALCAGE < 18] HAS THIS FACILITY APPROVED PARTICIPATION FOR 16 AND 17-YEAR OLDS?


NOTE: THIS INFORMATION IS INCLUDED IN SECTION ? OF THE FACILITY LOGISTICS PLAN.


1 YES

2 NO


A4a [IF CALCAGE < 16 AND I4 = 1] Thank you for your willingness to participate, but we cannot interview anyone who is younger than 16 for this study.


[IF CALCAGE < 18 AND 14 = 2] Thank you for your willingness to participate, but we cannot interview anyone who is younger than 18 for this study.


PRESS NEXT BUTTON TO END INTERVIEW.


Note to Programmers: Route these cases to M20


A4b [IF A4 = DK/REF] Thank you for your willingness to participate, but we cannot interview if we don’t know how old you are.


PRESS NEXT BUTTON TO END INTERVIEW.


Note to Programmers: Route these cases to M20


B1. How old were you the first time you were arrested or taken into custody for any offense?


AGE: ________________ [RANGE: 6 – CALCAGE]

DK/REF


A5 When were you admitted to this facility?


A5a. 2-DIGIT MONTH: _________ [RANGE: 1 – 12] DK/REF

A5b. 2-DIGIT DAY: ____________ [RANGE: 1 – 31] DK/REF

A5c. 4-DIGIT YEAR: ___________ [RANGE: 1915 – current year] DK/REF



A6 [IF A5a = DK/REF AND A5c NE DK OR REF] What time of year was it? Was it winter, spring, summer, or fall when you were admitted to this facility?


1 WINTER

2 SPRING

3 SUMMER

4 FALL

DK/REF


DEFINE CALCTIME:

CALCTIME = CALCULATED BY “SUBTRACTING” DATE OF INCARCERATION FROM DATE OF INTERVIEW AND THEN ROUNDING. (less than 2 months report as days; 2 – 11 months report as months; 12 months or more round to nearest year)


DEFINE DOAFILL1:

If facility admission date is at least 12 months ago then DOAFILL1 = During the past 12 months

If facility admission date is less than 12 months ago then DOAFILL1 = Since you arrived at this facility


DEFINE DOAFILL2:

If facility admission date is at least 12 months ago then DOAFILL2 = during the past 12 months

If facility admission date is less than 12 months ago then DOAFILL2 = since you arrived at this facility


A7 [IF CALCTIME NE MISSING] That means you have been here for about [CALCTIME]. Is that correct?


1 YES

2 NO


A8 [IF (A5c=DK OR REF) OR A7 = 2] How long have you been in this facility?


INTERVIEWER: PROBE THOROUGHLY TO AVOID A DK OR REFUSE RESPONSE IF AT ALL POSSIBLE.


1 LESS THAN 1 WEEK

2 AT LEAST 1 WEEK BUT LESS THAN 1 MONTH

3 AT LEAST 1 MONTH BUT LESS THAN 2 MONTHS

4 AT LEAST 2 MONTHS BUT LESS THAN 6 MONTHS

5 AT LEAST 6 MONTHS BUT LESS THAN 1 YEAR

6 AT LEAST 1 YEAR BUT LESS THAN 5 YEARS

7 AT LEAST 5 YEARS BUT LESS THAN 10 YEARS

8 10 YEARS OR MORE

DK/REF


UPDATE DOAFILL1:

IF A8 = 1 – 5 THEN DOAFILL1 = Since you arrived at this facility

IF A8 = 6 – 8 OR DK OR REF, THEN DOAFILL1 = During the past 12 months

UPDATE DOAFILL2:

IF A8 = 1 – 5 THEN DOAFILL2 = since you arrived at this facility

IF A8 = 6 – 8 OR DK OR REF, THEN DOAFILL2 = during the past 12 months

A9. Which of the following best describes the housing unit where you spent last night?


1 An open dorm

2 A dorm with cubicles

3 A unit with cells

4 A unit with rooms

5 An area not originally intended as housing, such as a gym, classroom, or day room

6 Administrative segregation or solitary confinement

7 NONE OF THESE

DK/REF


A10. [IF A9 = 6 OR DK] Where did you spend last night?


_________________________ [ALLOW 80 CHARACTERS]


A10. How tall are you?


Feet: ___________

Inches: _____________


DK/REF


[NOTE TO PROGRAMMERS: THIS ITEM CAN BE COPIED FROM THE YEAR 1 INSTRUMENT.]


SECTION C: ACASI Tutorial


TIME STAMP HERE


C1 [NO AUDIO REQUIRED] You will complete the rest of this interview on your own using the computer and headphones. Before you start, we’ll go through a short practice session together so you can learn how to use this computer to answer the interview questions. After this introduction, I will move away from the computer and will not be able to see your answers so that you can take the interview in privacy.


You do not need the mouse or keyboard to answer questions. You can simply touch the buttons on the screen using your finger.


MOVE COMPUTER SO RESPONDENT CAN SEE THE SCREEN.

For each question, the answers will appear as buttons on the screen, like these yes and no buttons. POINT TO YES AND NO BUTTONS ON SCREEN. To choose an answer you will need to use your finger to touch the button for your answer on the computer screen, like this.

PRESS YES BUTTON.

After you choose your answer, you must touch the NEXT button at the bottom of the screen. TOUCH THE NEXT BUTTON.

C2 [NO AUDIO REQUIRED] If you want to go back to the previous question, this is the BACK button. POINT TO BACK BUTTON.


Now I will show you how to use the back button to go back to the previous question and change the answer to no.


NOW DEMONSTRATE USE OF BACK BUTTON BY PRESSING IT TO GO BACK TO THE PREVIOUS SCREEN AND CHANGE YOUR ANSWER TO NO. THEN RETURN TO THIS SCREEN BY PRESSING NEXT.


You can also use the back button to see your previous answer without changing it.


If you don’t know the answer to the question, touch the DON’T KNOW button [POINT TO DON’T KNOW ] at the bottom of the screen and you will go on to the next question. PRESS DON’T KNOW BUTTON.


C3 [NO AUDIO REQUIRED] If you don’t want to answer the question, you can touch the REFUSE button [POINT TO THE REFUSE BUTTON]and you will go on to the next question. PRESS REFUSE BUTTON.



C4 [NO AUDIO REQUIRED] If you want the computer to read the question again, you can press the REPEAT button [POINT TO REPEAT BUTTON].


C5 [NO AUDIO REQUIRED] You can adjust the volume here [DEMONSTRATE VOLUME ADJUSTMENT, ON THE HEADPHONE CORD]. Or if you want to turn the volume off you can adjust it on your headphones or take your headphones off.


Please put on your headphones. When you are ready, let me know.


MOVE COMPUTER SO RESPONDENT CAN USE IT. ONCE RESPONDENT HAS HEADPHONES ON, TOUCH THE NEXT BUTTON SO RESPONDENT CAN BEGIN PRACTICE SESSION.



PLAY AUDIO FOR ALL FOLLOWING SCREENS

C6 This screen will play while you adjust the volume in your headphones. When you have adjusted the volume to a level that is comfortable to you, touch the NEXT button on the bottom of your screen to continue with the practice session.



C7 Welcome to RTI’s self-interviewing system, which lets you control the interview and answer in complete privacy. In this system, you can read the questions on the computer screen and hear them read through the headphones. Nobody, not even your interviewer will know how you answer the questions. [IF CALAGE = 16 OR 17] Because you are under 18 I want to remind you that if you speak to your interviewer about any abuse you have experienced at this facility she or her supervisor may need to report it to the agency in this state that investigates abuse.


First, you will learn how to use the system and complete some practice questions. You will learn how to enter answers and how to back-up if you make a mistake and want to change an answer.

If you would like to just see the questions on the screen, you can turn off the voice on your headphones or take them off.

Touch the large NEXT button on the bottom of your screen.


C8 After you hear the question, you will hear the possible answers. Each answer will be highlighted as it is read. To answer the question, you simply use your finger to touch the button on the screen with your answer on it and then touch the NEXT button.


Do you like ice cream?


Yes

No


C9 The last question was a Yes-No question. Other questions will have more answers to choose from, and you will pick your answer from a list.


What is your favorite color? Touch the answer button on the screen that best fits you and then touch the NEXT button.


Blue

Red

Yellow

Green

Some other color


C10 For some questions you will enter your answer using a keypad like the one shown below. Try using the keypad to answer the question below. If you need to change your answer touch the ‘Clear’ button to remove what you have already entered and then put in a new answer.


How many brothers and sisters do you have?


NUMBER: __________ [RANGE: 0 – 999]


C11 Sometimes there will be more than one question to answer on a screen like the example shown below. For these questions the answer choices and the Refused and Don’t Know buttons are shown to the right of each question. Try answering the questions below and then press the NEXT button to go to the next screen.


Has a doctor or other health care provider ever told you that you are allergic to…


Pollen? Y/N/DK/REF

Dust? Y/N/DK/REF

Mold? Y/N/DK/REF


C13 You can tell the computer to repeat a question by touching the REPEAT button. Try this now.


How many times did you listen to this question?


I have listened to this screen more than once.

I have only listened to this screen one time


C14 If you have any questions, ask your interviewer now. If not, tell the interviewer you are ready to begin and she will move away from the computer. Touch the NEXT button when you are ready to begin.



CONTINUATION OF SECTION A: DEMOGRAPHICS


TIME STAMP HERE


A11 Are you of Hispanic, Latino, or Spanish origin?


1 Yes

2 No

DK/REF


A12 [IF A11 = 1] Which of these categories describes your origin or descent?

Yes

No

A12a. Mexican-American?

1

2

A12b. Mexican?

1

2

A12c. Cuban?

1

2

A12d. Puerto Rican or other Caribbean?

1

2

A12e. Central or South American Spanish?

1

2

A12f. Some other Spanish group?

1

2


A13 Which of these categories describes your race? You may respond “Yes” to one or more of these categories.




Yes

No

A13a. White?

1

2

A13b. Black or African American?

1

2

A13c. American Indian or Alaska Native?

1

2

A13d. Asian?

1

2

A13e. Native Hawaiian or other Pacific Islander?

1

2


A14a [IF GENDER = FEMALE] How tall are you?

  1. Less than 4 feet

  2. 4 feet 1 inch – 4 feet 6 inches

  3. 4 feet 7 inches – 4 feet 11 inches

  4. 5 feet – 5 feet 2 inches

  5. 5 feet 3 inches – 5 feet 5 inches

  6. 5 feet 6 inches – 5 feet 8 inches

  7. 5 feet nine inches or taller

DK/REF


A15b IF GENDER = MALE] How tall are you?

1 Less than 4 feet

2 4 feet 1 inch – 4 feet 6 inches

3 4 feet 7 inches – 4 feet 11 inches

4 5 feet – 5 feet 4 inches

5 5 feet 5 inches – 5 feet 8 inches

6 5 feet 9 inches – 5 feet 11 inches

7 6 feet – 6 feet 2 inches

8 6 feet three inches – 6 feet five inches

9 6 feet six inches or taller

DK/REF


A16 How much do you currently weigh in pounds?


CURRENT WEIGHT: __________________ [RANGE: 50 – 700]

DK/REF


A17 Did you graduate from high school?


1 Yes

2 No

DK/REF


A18 [IF A17 = 1] Did you receive a high school diploma or a GED for finishing high school?


1 HIGH SCHOOL DIPLOMA

2 GED

DK/REF


A19 [If A17 = 2] Did you receive a GED?


1 Yes

2 No

DK/REF


A20 [IF A17 =1 OR A19 =1] What is the highest level of school you have completed?


1 High School or GED

2 Some college but you did not receive a degree

3 Associate Degree

4 Bachelor’s Degree

5 An advanced degree such as a Master’s, MBA, or PhD

DK/REF


A21 [IF A17 =2 AND A19 =2] Did you attend high school?


1 Yes

2 No

DK/REF

Section V – Veteran Status


TIME STAMP HERE


The next questions are about service in the United States Armed Forces.


V1. Have you ever served in the United States Armed Forces?


1 Yes

2 No

DK/REF


V2. [IF V1 = 1 OR DK OR REF] Have you served in the…

Yes

No

V2a Army, including the Army National Guard or Reserve?

1

2

V2b Navy, including the Reserve?

1

2

V2c. Marine Corps, including the Reserve?

1

2

V2d. Air Force, including the Air National Guard or Reserve?

1

2

V2e. Coast Guard, including the Reserve?

1

2


V3. [IF V1 = 1 OR V2a = 1 OR V2b = 1 OR V2c = 1 OR V2d = 1 OR V2e = 1] In what year did you first enter the United States Armed Forces? Use the keypad below to enter the year.


YEAR: ___ [RANGE: 1920 – CURRENT YEAR]

DK/REF


V4. [IF V1 = 1 OR V2a = 1 OR V2b = 1 OR V2c = 1 OR V2d = 1 OR V2e = 1] Are you currently serving in the United States Armed Forces?


1 Yes

2 No

DK/REF


V5. [IF V4 = 2] In what year were you last discharged from the United States Armed Forces? Use the keypad below to enter the year.

YEAR: ___ [RANGE: 1920 – CURRENT YEAR]

DK/ERF


V6a. [IF V4 = 1] While serving in the United States Armed Forces, have you seen combat in a line or combat unit?


[IF V4 = 2 OR DK/REF] While you were serving in the United States Armed Forces, did you see combat in a line or combat unit?


1 Yes

2 No

DK/REF


V6b. [IF V6a = 1] Did you see combat in a line or combat unit in…

Yes

No

V6b1. World War II?

1

2

V6b2. the Korean Conflict?

1

2

V6b3. the Vietnam War?

1

2

V6b4. the Persian Gulf War?

1

2

V6b5. Afghanistan?

1

2

V6b6. Iraq

1

2

V6b7. Some other military operation which may include peacekeeping operations

1

2



V7. [IF V4 = 1] Altogether, how much time have you served in the United States Armed Forces?


[IF V4 = 2 OR DK/REF] Altogether, how much time did you serve in the United States Armed Forces?


1 Less than 1 year

2 At least one year but less than 3 years

3 At least 3 years but less than 5 years

4 At least 5 years but less than 10 years

5 At least 10 years but less than 15 years

6 At least 15 years but less than 20 years

7 20 years or more

DK/REF


V8. [IF V4 = 2] What type of discharge did you receive from the United States Armed Forces?


1 Honorable

2 General under honorable conditions

3 Other than honorable

4 Bad conduct

5 Dishonorable

6 Some other type of discharge

DK/REF

Section B – Criminal History


TIME STAMP HERE


B0. These next questions are about your experience with crime and the criminal justice system.


B2. Altogether, how many times have you been arrested or taken into custody for any offense?


1 One time

2 2-3 times

3 4-10 times

4 11 times or more

DK/REF


B3. Before you were admitted to this facility, had you ever spent time as an adult or juvenile in a prison, jail, or other correctional facility?


1 Yes

2 No

DK/REF


B3a. [IF B3 = 1 OR DK OR REF] Before you were admitted to this facility, how much time altogether had you spent as an adult or juvenile in a prison, jail, or other correctional facility?


1 Less than 30 days

2 At least 30 days but less than 6 months

3 At least 6 months but less than 1 year

4 At least 1 year but less than 5 years

5 5 years or more

DK/REF


B4. [IF I0 = 1] Are you currently in this facility because you have been sentenced to serve time for an offense?


1 Yes

2 No

DK/REF


B5. [IF B4 = 2 OR DK OR REF] Are you currently being held in this facility for a property offense? Property offenses include crimes like burglary, larceny, theft, auto theft, bad checks, fraud, forgery, arson, or possession of stolen goods.


1 Yes

2 No

DK/REF


B6. [IF B4 = 2 OR DK OR REF] Are you currently being held in this facility for a drug offense? Drug offenses include crimes like possessing, selling, trafficking, importing, smuggling, or manufacturing illegal drugs or drug paraphernalia.


1 Yes

2 No

DK/REF


B7. [IF B4 = 2 OR DK OR REF] Are you currently being held in this facility for a violent offense? Violent offenses include crimes like physical or sexual assault, rape, robbery, manslaughter, murder, attempted murder, or kidnapping.


1 Yes

2 No

DK/REF


B8. [IF B4 = 2 OR DK OR REF] Are you currently being held in this facility for other crimes against people? Other crimes against people include crimes like vehicular homicide, hit and run, reckless endangerment, child neglect, harassment, or stalking.


1 Yes

2 No

DK/REF


B9. [IF B4 = 2 OR DK OR REF] Are you currently being held in this facility for a sexual offense? Sexual offenses include crimes like rape, statutory rape, sexual assault, child molestation, pornography, incest, or indecent exposure.


1 Yes

2 No

DK/REF


B10. [IF B4 = 2 OR DK OR REF] Are you currently being held in this facility for a probation or parole violation?


1 Yes

2 No

DK/REF


B11. [IF B4 = 2 OR DK OR REF] Are you currently being held in this facility for a procedural violation? Procedural violations include things like failure to appear in court, violating a restraining order, failure to obey a lawful order of a police officer, contempt, escape, resisting arrest without violence, or a regulatory or tax offense.


1 Yes

2 No

DK/REF


B12. [IF B4 = 2 OR DK OR REF] Are you currently being held in this facility for driving under the influence or driving while intoxicated?


1 Yes

2 No

DK/REF


B13. [IF B4 = 2 OR DK OR REF] Are you currently being held in this facility for some other offense? Other offenses include crimes like loitering, prostitution, gambling, drunkenness, disorderly conduct, trespassing, minor traffic violations, weapons charges, or immigration violations.


1 Yes

2 No

DK/REF


B14. [IF I0 = 2 OR IF B4 = 1] Are you currently serving time in this facility for a property offense? Property offenses include crimes like burglary, larceny, theft, auto theft, bad checks, fraud, forgery, arson, or possession of stolen goods.

1 Yes

2 No

DK/REF


B15. [IF I0 = 2 OR IF B4 = 1] Are you currently serving time in this facility for a drug offense? Drug offenses include crimes like possessing, selling, trafficking, importing, smuggling, or manufacturing illegal drugs or drug paraphernalia.


1 Yes

2 No

DK/REF


B16. [IF (I0 = 2 OR IF B4 = 1] Are you currently serving time in this facility for a violent offense? Violent offenses include crimes like physical or sexual assault, rape, robbery, manslaughter, murder, attempted murder, or kidnapping.


1 Yes

2 No

DK/REF


B17. [IF I0 = 2 OR IF B4 = 1] Are you currently serving time in this facility for other crimes against people? Other crimes against people include crimes like vehicular homicide, hit and run, reckless endangerment, child neglect, harassment, or stalking.


1 Yes

2 No

DK/REF


B18. [IF I0 = 2 OR IF B4 = 1] Are you currently serving time in this facility for a sexual offense? Sexual offenses include crimes like rape, statutory rape, sexual assault, child molestation, pornography, incest, or indecent exposure.


1 Yes

2 No

DK/REF


B19. [IF I0 = 2 OR IF B4 = 1] Are you currently serving time in this facility for a probation or parole violation?


1 Yes

2 No

DK/REF


B20. [IF I0 = 2 OR IF B4 = 1] Are you currently serving time in this facility for a procedural violation? Procedural violations include things like failure to appear in court, violating a restraining order, failure to obey a lawful order of a police officer, contempt, escape, resisting arrest without violence, or a regulatory or tax offense.


1 Yes

2 No

DK/REF


B21. [IF I0 = 2 OR IF B4 = 1] Are you currently serving time in this facility for driving under the influence or driving while intoxicated?

1 Yes

2 No

DK/REF


B22. [IF I0 = 2 OR IF B4 = 1] Are you currently serving time in this facility for some other offense? Other offenses include crimes like loitering, prostitution, gambling, drunkenness, disorderly conduct, trespassing, minor traffic violations, weapons charges, or immigration violations.


1 Yes

2 No

DK/REF


B23. [IF (I0 = 1 AND B4 =1) OR IF I0 = 2] Are you currently serving a life sentence or a life sentence without parole?


1 Yes

2 No

DK/REF


B24. [IF B23 = 2 OR DK OR REF] Are you currently serving a death sentence?


  1. Yes

  2. No

DK/REF


B25a. [IF (I0 = 1 AND B4 =1) AND (B23 = 2 OR DK OR REF) OR (B24 = 2 OR DK OR REF)] What is your total maximum sentence length for all of the sentences you are serving?


1 Less than 30 days

2 At least 30 days but less than 6 months

3 At least 6 months but less than 1 year

4 At least 1 year but less than 5 years

5 5 years or more

DK/REF


B25b. [IF I0 = 2 AND (B24 = 2 OR DK OR REF) OR (B24 = 2 OR DK OR REF)] What is your total maximum sentence length for all of the sentences you are serving?


1 Less than 1 year

2 At least 1 year but less than 5 years

3 At least 5 years but less than 10 years

4 At least10 years but less than 20 years

5 20 years or more

DK/REF


B26. [IF I0 = 1 AND B23 NE 1 AND B24 NE 1] Do you have a definite date on which you expect to be released from jail or prison?


[IF I0 = 2 AND B23 NE 1 AND B24 NE 1] Do you have a definite date on which you expect to be released from prison?


1 Yes

2 No

DK/REF


B27. [(IF B26 = 1 OR DK OR REF] How much more time do you think you will serve before you are released?


1 Less than 30 days

2 At least 30 days but less than 1 year

3 At least 1 year but less than 5 years

4 At least 5 years but less than 10 years

5 10 years or more

DK/REF



SECTION D: MISCELLANEOUS


TIME STAMP HERE


D1 Are you currently married, widowed, divorced or separated, or have you never married?

1 Married

2 Widowed

3 Divorced

4 Separated (For reasons other than incarceration)

5 Never married

DK/REF


D2 Are you male, female, or transgender?


1 Male

2 Female

3 Transgender

DK/REF


D3 Before you entered this facility, about how many different partners had you ever had sex with? By sex we mean vaginal, oral, or anal sex.


1 0

2 1

3 2 – 4

4 5 – 10

5 11 – 20

6 21 or more

DK/REF


D4 [IF D3 NE 1] Before you entered this facility, had you had sex with men only, women only, or both men and women?


1 Men only

2 Women only

3 Both men and women

DK/REF


D5 Do you consider yourself to be heterosexual or ‘straight’, bisexual, or homosexual or gay?


1 ‘Straight,’ which is also called Heterosexual

2 Bi-sexual

3 [D2 = 1] Homosexual or Gay

[D2 = 2 OR 3 OR DK OR REF] Homosexual, Gay, or Lesbian

4. Other

DK/REF



NOTE: Randomization occurs here. The remainder of this instrument shows routing only for the 10% sample.

Section R – Mental Health


TIME STAMP HERE


R1 The next questions are about how you have been feeling during the past 30 days.


About how often during the past 30 days did you feel nervous?


1 All of the time

2 Most of the time

3 Some of the time

4 A little of the time

5 None of the time

DK/REF


R2 During the past 30 days, about how often did you feel hopeless?


1 All of the time

2 Most of the time

3 Some of the time

4 A little of the time

5 None of the time

DK/REF


R3 During the past 30 days, about how often did you feel restless or fidgety?


1 All of the time

2 Most of the time

3 Some of the time

4 A little of the time

5 None of the time

DK/REF


R4 How often in the past 30 days did you feel so depressed that nothing could cheer you up?


1 All of the time

2 Most of the time

3 Some of the time

4 A little of the time

5 None of the time

DK/REF

R5 About how often in the past 30 days did you feel that everything was an effort?


1 All of the time

2 Most of the time

3 Some of the time

4 A little of the time

5 None of the time

DK/REF




R6 About how often in the past 30 days did you feel worthless?


1 All of the time

2 Most of the time

3 Some of the time

4 A little of the time

5 None of the time

DK/REF


R7 Did you ever in your life have a month or longer when you felt sad or depressed most of the time?


1 Yes

2 No

DK/REF

R8 [IF R7 = 1] During those times when your feelings of sadness or depression were at their worst, did you also have other problems like low energy, changes in your sleep or appetite, or problems with your ability to concentrate?


1 Yes

2 No

DK/REF

R9 [IF R8 = 1] You mentioned feeling sad or depressed for a month or longer in your life and having other problems like low energy, changes in your sleep or appetite, or an inability to concentrate. About how many weeks in the past 12 months did you have problems like this?


Use the keypad below to enter the number of weeks. You can enter any number from 1 to 52.


NUMBER OF WEEKS: _____________ [RANGE: 1 – 52]

DK/REF


R10 Did you ever in your life have times lasting a month or longer when you were nervous, edgy, anxious, or worried most of the time?

1 Yes

2 No

DK/REF

R11 [IF R10 = 1] During those times, did you also have other problems like being restless, irritable, easily tired, or have difficulty falling asleep?

1 Yes

2 No

DK/REF


R12 [IF R11 = 1] About how many weeks in the last 12 months did you have problems like this – of being nervous or anxious or worried along with other problems like being irritable or having trouble sleeping?


Use the keypad below to enter the number of weeks. You can enter any number from 1 to 52.


NUMBER OF WEEKS: _____________ [RANGE 1 – 52]

DK/REF



R13 Some people have feelings of fright or panic. They have physical sensations like a pounding heart, shortness of breath, dizziness, or a feeling like they are going to throw up. They sometimes even feel like they are going to lose control, go crazy, or die. Did you ever in your life have an episode like this, often called an anxiety or panic attack?

1 Yes

2 No

DK/REF

R14 [IF R13 = 1] About how many weeks in the last 12 months did you have at least one anxiety or panic attack?


Use the keypad below to enter the number of weeks. You can enter any number from 1 to 52.


NUMBER OF WEEKS: ____________ [RANGE: 1 – 52]

DK/REF


R15 Did you ever in your life have anger attacks -- when all of a sudden you lost control and either yelled, broke things, or tried to hurt someone?

1 Yes

2 No

DK/REF


R16 [IF R15 = 1] About how many weeks in the last 12 months did you have at least one anger attack?


Use the keypad below to enter the number of weeks. You can enter any number from 1 to 52.


NUMBER OF WEEKS: ____________ [RANGE: 1 – 52]

DK/REF


R17 Some people have times lasting several days or longer when they feel much more excited or manic or more full of energy than usual. Their minds go too fast. They talk a lot. They are very restless and sometimes do things unusual for them, such as driving too fast or spending too much money. Have you ever in your life had an episode like this lasting several days or longer?


1 Yes

2 No

DK/REF


R18 [IF R17 = 1] About how many weeks in the last 12 months did you have an episode of being more excited or manic or more full of energy than usual?


Use the keypad below to enter the number of weeks. You can enter any number from 1 to 52.


ENTER NUMBER OF WEEKS: ______________ [RANGE: 1 – 52]

DK/REF


R19 [IF R17 = 2 OR DK OR REF] Have you ever in your life had an episode lasting several days or longer when most of the time you were so irritable or grouchy that you either started arguments, shouted at people, or hit people?


1 Yes

2 No

DK/REF



R20 [IF R19 = 1] About how many weeks in the last 12 months did you have an episode of being very irritable or grouchy?


Use the keypad below to enter the number of weeks. You can enter any number from 1 to 52.


ENTER NUMBER OF WEEKS: __________ [RANGE: 1 – 52]

DK/REF


R21 Did you ever in your life have any of the following experiences happen to you:

Yes

No

R21a A serious fight or physical assault?

1

2

R21a1. A sexual assault?

1

2

R21b. A life-threatening accident or injury?

1

2

R21c. The murder or suicide of a loved one?

1

2

R21d. The accidental death of a loved one?

1

2

R21e. Witnessed someone being seriously injured or killed?

1

2

R21f. Any experience that put you at risk of death?

1

2



R22 [IF R21a = 1 OR R21b = 1 OR R21c = 1 OR R21d = 1 OR R21e = 1 OR R21f = 1] Experiences like the ones listed on the last screen can cause emotional problems like nightmares, very upsetting thoughts, anxiety, depression, feeling detached from other people, and avoiding situations that remind you of the experience. Did you ever have problems like these after any of the experiences that have happened to you?

1 Yes

2 No

DK/REF


R23 [IF R22 = 1] What is the longest amount of time you ever had any kinds of emotional problems after any of the experiences that have happened to you?


1 Less than 1 month

2 1 – 3 months

3 4 – 6 months

4 7 – 12 months

5 More than a year

DK/REF


R24 – R35: ALL RESPONDENTS

R24 Have you ever been told by a mental health professional, such as a psychiatrist or psychologist, that you had…

Yes

No

R24a. Manic depression, a bipolar disorder, or mania?

1

2

R24b. A depressive disorder?

1

2

R24c. Schizophrenia or another psychotic disorder?

1

2

R24d. Post-traumatic stress disorder or PTSD?

1

2

R24e. Another anxiety disorder, such as panic disorder or OCD?

1

2

R24f. A personality disorder, such as antisocial or borderline personality

1

2

R24g. A mental or emotional condition other than those listed above?

1

2


R25 The next questions are about any times you may have stayed overnight in any type of hospital or other facility for any problem with your emotions, nerves, or mental health. Please do not include any overnight hospital stays for alcohol or drug use.


Touch the NEXT button to go to the next screen.


R26 Have you ever stayed overnight or longer in any type of hospital or other facility to receive treatment or counseling for any problem you were having with your emotions, nerves, or mental health?


1 Yes

2 No

DK/REF


R27 [IF R26 = 1 AND FACILITY = JAIL] During the 12 months before you were admitted to this facility, did you stay overnight or longer in any type of hospital or other facility to receive treatment or counseling for any problem you were having with your emotions, nerves, or mental health?


[IF R26 = 1 AND FACILITY = PRISON] During the 12 months before you were admitted to any facility to serve time on your current sentence, did you stay overnight or longer in any type of hospital or other facility to receive treatment or counseling for problems you were having with your emotions, nerves, or mental health?


1 Yes

2 No

DK/REF


R28 The next questions are about services you may have received for any problem with your emotions, nerves, or mental health. As you answer these questions please do not include any services you may have received for drug or alcohol use. Some questions ask about prescription medicine. Prescription medicines are drugs that you take if a doctor authorizes them for you.


Touch the NEXT button to go to the next screen.


R29 Have you ever taken any prescription medicine for any problem you were having with your emotions, nerves, or mental health?


1 Yes

2 No

DK/REF


R30 [IF B4 = 1 AND R29 = 1] At the time of the offense for which you are currently serving time, were you taking prescription medicine for any problem you were having with your emotions, nerves, or mental health?


[IF B4 = 2 OR DK OR REF AND R29 = 1] At the time of the offense for which you are currently being held, were you taking prescription medicine for any problem you were having with your emotions, nerves, or mental health?


1 Yes

2 No

DK/REF


R31 [IF FACILITY = PRISON AND R29 = 1] Since you were admitted to any facility to serve time on your current sentence, have you taken prescription medicine for any problem you were having with your emotions, nerves, or mental health?


[IF FACILITY = JAIL AND R29 = 1] Since you were admitted to this facility, have you taken prescription medicine for any problem you were having with your emotions, nerves, or mental health?


1 Yes

2 No

DK/REF


R32 [IF R31 = 1] Are you currently taking prescription medicine for any problem with your emotions, nerves, or mental health?


1 Yes

2 No

DK/REF


R33 Have you ever received counseling or therapy from a trained professional such as a psychiatrist, psychologist, social worker, or nurse for any problem you were having with your emotions, nerves, or mental health?


1 Yes

2 No

DK/REF


R34 [IF R33 = 1 AND FACILITY = PRISON] Since you were admitted to any facility to serve time on your current sentence, have you received counseling or therapy from a trained professional such as a psychiatrist, psychologist, social worker, or nurse for any problem you were having with your emotions, nerves, or mental health?


[IF R33 = 1 AND FACILITY = JAIL] Since you were admitted to this facility, have you received counseling or therapy from a trained professional such as a psychiatrist, psychologist, social worker, or nurse for any problem you were having with your emotions, nerves, or mental health?


1 Yes

2 No

DK/REF


R35 [IF R33 = 1] Are you currently receiving any counseling or therapy from a trained professional such as a psychiatrist, psychologist, social worker, or nurse for any problem with your emotions, nerves, or mental health?


1 Yes

2 No

DK/REF


R36 [IF FACILITY TYPE = JAIL AND R24a = 1] At the time you were admitted to this facility, did you have manic depression, a bipolar disorder, or mania?


[IF FACILITY TYPE = PRISON AND R24a = 1] At the time you were admitted to any facility to serve time on your current sentence, did you have manic depression, a bipolar disorder, or mania?


1 Yes

2 No

DK/REF


R37 [IF FACILITY TYPE = JAIL AND R36 = 1] In the 30 days before you were admitted to this facility, were you taking any prescription medicine for your manic depression, bipolar disorder, or mania?


[IF FACILITY TYPE = PRISON AND R36 =1] In the 30 days before you were admitted to any facility to serve time on your current sentence, were you taking any prescription medicine for your manic depression, bipolar disorder, or mania?


1 Yes

2 No

DK/REF


R38 [IF FACILITY TYPE = JAIL AND R36 = 1] In the 30 days before you were admitted to this facility, were you receiving any medical treatment other than prescription medicine for your manic depression, bipolar disorder, or mania?


[IF FACILITY TYPE = PRISON AND R36 =1] In the 30 days before you were admitted to any facility to serve time on your current sentence, were you receiving any medical treatment other than prescription medicine for your manic depression, bipolar disorder, or mania?


1 Yes

2 No

DK/REF


R39 [IF FACILITY = JAIL AND R36 = 2] Since you were admitted to this facility, have you been told by a doctor, nurse, or other health care provider that you had manic depression, a bipolar disorder, or mania?


[IF FACILITY = PRISON AND R36 = 2] Since you were admitted to any facility to serve time on your current sentence, have you been told by a doctor, nurse, or other health care provider that you had manic depression, a bipolar disorder, or mania?


  1. Yes

  2. No

DK/REF


R40 [IF FACILITY = JAIL AND (R36 =1 OR R39 =1)] Since you were admitted to this facility, have you taken any prescription medicine for your manic depression, bipolar disorder, or mania?


[IF FACILITY = PRISON AND (R36 =1 OR R39 =1)] Since you were admitted to any facility to serve time on your current sentence, have you taken any prescription medicine for your manic depression, bipolar disorder, or mania?


1 Yes

2 No

DK/REF


R41 [IF FACILITY = JAIL AND (R36 =1 OR R39 =1)] Since you were admitted to this facility, have you received any medical treatment other than prescription medicine for your manic depression, bipolar disorder, or mania?


[IF FACILITY = PRISON AND (R36 =1 OR R39 =1)] Since you were admitted to any facility to serve time on your current sentence, have you received any medical treatment other than prescription medicine for your manic depression, bipolar disorder, or mania?


1 Yes

2 No

DK/REF


R42 [IF FACILITY = JAIL AND R39 = 1 AND R40 = 1], How soon after you were told that you had manic depression, a bipolar disorder, or mania did you start taking prescription medicine at this facility for manic depression, bipolar disorder, or mania?


[IF FACILITY = PRISON AND R39 = 1 AND R40 = 1] Think about when you were first told that you had manic depression, a bipolar disorder, or mania after you were admitted to any facility to serve time on your current sentence. How soon after you were told did you start taking prescription medicine for your manic depression, bipolar disorder, or mania?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


R43 [IF FACILITY = JAIL AND R39 = 1 AND R41 =1] How soon after you were told that you had manic depression, a bipolar disorder, or mania did you start receiving any medical treatment other than prescription medicine at this facility for manic depression, a bipolar disorder, or mania?


[IF FACILITY = PRISON AND R39 =1 AND R41 = 1] Think about when you were first told that you had manic depression, a bipolar disorder, or mania after you were admitted to any facility to serve time on your current sentence. How soon after you were told did you start receiving any medical treatment other than prescription medicine for your manic depression, bipolar disorder, or mania?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


R44 [IF FACILITY = JAIL AND R36 = 1 AND R40 = 1] How soon after you were admitted to this facility did you start taking prescription medicine for your manic depression, bipolar disorder, or mania?


[IF FACILITY = PRISON AND R36 = 1 AND R40 = 1] How soon after you were admitted to any facility to serve time on your current sentence did you start taking prescription medicine for your manic depression, bipolar disorder, or mania?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


R45 [IF FACILITY = JAIL AND R36 = 1 AND R41 = 1] How soon after you were admitted to this facility did you start receiving any medical treatment other than prescription medicine for your manic depression, bipolar disorder, or mania?


[IF FACILITY = PRISON AND R36 = 1 AND R41 = 1] How soon after you were admitted to any facility to serve time on your current sentence did you start receiving any medical treatment other than prescription medicine for your manic depression, bipolar disorder, or mania?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


R46 [IF R24a = 1] Are you currently taking prescription medicine for your manic depression, bipolar disorder, or mania?


1 Yes

2 No

DK/REF


R47 [IF R24a = 1] Are you currently receiving any medical treatment other than prescription medicine for your manic depression, bipolar disorder, or mania?


1 Yes

2 No

DK/REF


R48 [IF R46 = 2] Why aren’t you currently taking prescription medicine for your manic depression, bipolar disorder, or mania?

Yes

No

R48a. You have not seen a doctor to get the medicine

1

2

R48b. The doctor at the facility doesn’t think you need medicine

1

2

R48c. You don’t like taking the medicine

1

2

R48d. You don’t think you need the medicine

1

2

R48e. The facility is not willing to give the medicine to you

1

2

R48f. You would have to be transferred to a different facility to receive the medicine

1

2

R48g. You don’t currently have manic depression, bipolar disorder or mania

1

2

R48h. Some other reason

1

2


R49 [IF FACILITY TYPE = JAIL AND R24b = 1] At the time you were admitted to this facility, did you have a depressive disorder?


[IF FACILITY TYPE = PRISON AND R24b = 1] At the time you were admitted to any facility to serve time on your current sentence, did you have a depressive disorder?


1 Yes

2 No

DK/REF


R50 [IF FACILITY TYPE = JAIL AND R49 = 1] In the 30 days before you were admitted to this facility, were you taking any prescription medicine for your depressive disorder?


[IF FACILITY TYPE = PRISON AND R49 =1] In the 30 days before you were admitted to any facility to serve time on your current sentence, were you taking any prescription medicine for your depressive disorder?


1 Yes

2 No

DK/REF


R51 [IF FACILITY TYPE = JAIL AND R49 = 1] In the 30 days before you were admitted to this facility, were you receiving any medical treatment other than prescription medicine for your depressive disorder?


[IF FACILITY TYPE = PRISON AND R49 =1] In the 30 days before you were admitted to any facility to serve time on your current sentence, were you receiving any medical treatment other than prescription medicine for a depressive disorder?


1 Yes

2 No

DK/REF


R52 [IF FACILITY = JAIL AND R49 = 2] Since you were admitted to this facility, have you been told by a doctor, nurse, or other health care provider that you had a depressive disorder?


[IF FACILITY = PRISON AND R49 = 2] Since you were admitted to any facility to serve time on your current sentence, have you been told by a doctor, nurse, or other health care provider that you had a depressive disorder?


1 Yes

2 No

DK/REF


R53 [IF FACILITY = JAIL AND (R49 =1 OR R52 =1)] Since you were admitted to this facility, have you taken any prescription medicine for your depressive disorder?


[IF FACILITY = PRISON AND (R49 =1 OR R52 =1)] Since you were admitted to any facility to serve time on your current sentence, have you taken any prescription medicine for your depressive disorder?


1 Yes

2 No

DK/REF


R54 [IF FACILITY = JAIL AND (R49 =1 OR R52 =1)] Since you were admitted to this facility, have you received any medical treatment other than prescription medicine for your depressive disorder?


[IF FACILITY = PRISON AND (R49 =1 OR R52 =1)] Since you were admitted to any facility to serve time on your current sentence, have you received any medical treatment other than prescription medicine for your depressive disorder?


1 Yes

2 No

DK/REF


R55 [IF FACILITY = JAIL AND R52 = 1 AND R53 = 1] How soon after you were told that you had a depressive disorder did you start taking prescription medicine at this facility for your depressive disorder?


[IF FACILITY = PRISON AND R52 = 1 AND R53 = 1] Think about when you were first told that you had a depressive disorder after you were admitted to any facility to serve time on your current sentence. How soon after you were told did you start taking prescription medicine for your depressive disorder?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


R56 [IF FACILITY = JAIL AND R52 = 1 AND R54 =1] How soon after you were told that you had a depressive disorder did you start receiving any medical treatment other than prescription medicine at this facility for your depressive disorder?


[IF FACILITY = PRISON AND R52 =1 AND R54 = 1] Think about when you were first told that you had a depressive disorder after you were admitted to any facility to serve time on your current sentence. How soon after you were told did you start receiving any medical treatment other than prescription medicine for your depressive disorder?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


R57 [IF FACILITY = JAIL AND R49 = 1 AND R53 = 1] How soon after you were admitted to this facility did you start taking prescription medicine for your depressive disorder?


[IF FACILITY = PRISON AND R49 = 1 AND R53 = 1] How soon after you were admitted to any facility to serve time on your current sentence did you start taking prescription medicine for your depressive disorder?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


R58 [IF FACILITY = JAIL AND R49 = 1 AND R54 = 1] How soon after you were admitted to this facility did you start receiving any medical treatment other than prescription medicine for your depressive disorder?


[IF FACILITY = PRISON AND R49 = 1 AND R54 = 1] How soon after you were admitted to any facility to serve time on your current sentence did you start receiving any medical treatment other than prescription medicine for your depressive disorder?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


R59 [IF R24b = 1] Are you currently taking prescription medicine for your depressive disorder?


1 Yes

2 No

DK/REF


R60 [IF R24b = 1] Are you currently receiving any medical treatment other than prescription medicine for your depressive disorder?


1 Yes

2 No

DK/REF


R61 [IF R59 = 2] Why aren’t you currently taking prescription medicine for your depressive disorder?

Yes

No

R61a. You have not seen a doctor to get the medicine

1

2

R61b. The doctor at the facility doesn’t think you need medicine

1

2

R61c. You don’t like taking the medicine

1

2

R61d. You don’t think you need the medicine

1

2

R61e. The facility is not willing to give the medicine to you

1

2

R61f. You would have to be transferred to a different facility to receive the medicine

1

2

R61g. You don’t currently have a depressive disorder

1

2

R61h. Some other reason

1

2


R62 [IF FACILITY TYPE = JAIL AND R24c = 1] At the time you were admitted to this facility, did you have schizophrenia or another psychotic disorder?


[IF FACILITY TYPE = PRISON AND R24c = 1] At the time you were admitted to any facility to serve time on your current sentence, did you have schizophrenia or another psychotic disorder?


1 Yes

2 No

DK/REF


R63 [IF FACILITY TYPE = JAIL AND R62 = 1] In the 30 days before you were admitted to this facility, were you taking any prescription medicine for schizophrenia or another psychotic disorder?


[IF FACILITY TYPE = PRISON AND R62 =1] In the 30 days before you were admitted to any facility to serve time on your current sentence, were you taking any prescription medicine for schizophrenia or another psychotic disorder?


1 Yes

2 No

DK/REF


R64 [IF FACILITY TYPE = JAIL AND R62 = 1] In the 30 days before you were admitted to this facility, were you receiving any medical treatment other than prescription medicine for schizophrenia or another psychotic disorder?


[IF FACILITY TYPE = PRISON AND R62 =1] In the 30 days before you were admitted to any facility to serve time on your current sentence, were you receiving any medical treatment other than prescription medicine for schizophrenia or another psychotic disorder?


1 Yes

2 No

DK/REF


R65 [IF FACILITY = JAIL AND R62 = 2] Since you were admitted to this facility, have you been told by a doctor, nurse, or other health care provider that you had schizophrenia or another psychotic disorder?


[IF FACILITY = PRISON AND R62 = 2] Since you were admitted to any facility to serve time on your current sentence, have you been told by a doctor, nurse, or other health care provider that you had schizophrenia or another psychotic disorder?


1 Yes

2 No

DK/REF


R66 [IF FACILITY = JAIL AND (R62 =1 OR R65 =1)] Since you were admitted to this facility, have you taken any prescription medicine for schizophrenia or another psychotic disorder?


[IF FACILITY = PRISON AND (R62 =1 OR R65 =1)] Since you were admitted to any facility to serve time on your current sentence, have you taken any prescription medicine for schizophrenia or another psychotic disorder?


1 Yes

2 No

DK/REF


R67 [IF FACILITY = JAIL AND (R62 =1 OR R65 =1)] Since you were admitted to this facility, have you received any medical treatment other than prescription medicine for schizophrenia or another psychotic disorder?


[IF FACILITY = PRISON AND (R62 =1 OR R65 =1)] Since you were admitted to any facility to serve time on your current sentence, have you received any medical treatment other than prescription medicine for schizophrenia or another psychotic disorder?


1 Yes

2 No

DK/REF


R68 [IF FACILITY = JAIL AND R65 = 1 AND R66 = 1] How soon after you were told that you had schizophrenia or another psychotic disorder did you start taking prescription medicine at this facility for schizophrenia or another psychotic disorder?


[IF FACILITY = PRISON AND R65 = 1 AND R66 = 1] Think about when you were first told that you had schizophrenia or another psychotic disorder after you were admitted to any facility to serve time on your current sentence. How soon after you were told did you start taking prescription medicine for schizophrenia or another psychotic disorder?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


R69 [IF FACILITY = JAIL AND R65 = 1 AND R67 =1] How soon after you were told that you had schizophrenia or another psychotic disorder did you start receiving any medical treatment other than prescription medicine at this facility for schizophrenia or another psychotic disorder?


[IF FACILITY = PRISON AND R65 =1 AND R67 = 1] Think about when you were first told that you had schizophrenia or another psychotic disorder after you were admitted to any facility to serve time on your current sentence. How soon after you were told did you start receiving any medical treatment other than prescription medicine for schizophrenia or another psychotic disorder?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


R70 [IF FACILITY = JAIL AND R62 = 1 AND R66 = 1] How soon after you were admitted to this facility did you start taking prescription medicine for schizophrenia or another psychotic disorder?


[IF FACILITY = PRISON AND R62 = 1 AND R66 = 1] How soon after you were admitted to any facility to serve time on your current sentence did you start taking prescription medicine for schizophrenia or another psychotic disorder?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


R71 [IF FACILITY = JAIL AND R62 = 1 AND R67 = 1] How soon after you were admitted to this facility did you start receiving any medical treatment other than prescription medicine for schizophrenia or another psychotic disorder?


[IF FACILITY = PRISON AND R62 = 1 AND R67 = 1] How soon after you were admitted to any facility to serve time on your current sentence did you start receiving any medical treatment other than prescription medicine for schizophrenia or another psychotic disorder?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


R72 [IF R24c = 1] Are you currently taking prescription medicine for schizophrenia or another psychotic disorder?


1 Yes

2 No

DK/REF


R73 [IF R24c = 1] Are you currently receiving any medical treatment other than prescription medicine for schizophrenia or another psychotic disorder?


1 Yes

2 No

DK/REF


R74 [IF R72 = 2] Why aren’t you currently taking prescription medicine for schizophrenia or another psychotic disorder?

Yes

No

R74a. You have not seen a doctor to get the medicine

1

2

R74b. The doctor at the facility doesn’t think you need medicine

1

2

R74c. You don’t like taking the medicine

1

2

R74d. You don’t think you need the medicine

1

2

R74e. The facility is not willing to give the medicine to you

1

2

R74f. You would have to be transferred to a different facility to receive the medicine

1

2

R74g. You don’t currently have schizophrenia or another psychotic disorder

1

2

R74h. Some other reason

1

2


R75 [IF FACILITY TYPE = JAIL AND R24d = 1] At the time you were admitted to this facility, did you have post-traumatic stress disorder or PTSD?


[IF FACILITY TYPE = PRISON AND R24d = 1] At the time you were admitted to any facility to serve time on your current sentence, did you have post-traumatic stress disorder or PTSD?


1 Yes

2 No

DK/REF


R76 [IF FACILITY TYPE = JAIL AND R75 = 1] In the 30 days before you were admitted to this facility, were you taking any prescription medicine for your post-traumatic stress disorder or PTSD?


[IF FACILITY TYPE = PRISON AND R75 =1] In the 30 days before you were admitted to any facility to serve time on your current sentence, were you taking any prescription medicine for your post-traumatic stress disorder or PTSD?


1 Yes

2 No

DK/REF


R77 [IF FACILITY TYPE = JAIL AND R75 = 1] In the 30 days before you were admitted to this facility, were you receiving any medical treatment other than prescription medicine for your post-traumatic stress disorder or PTSD?


[IF FACILITY TYPE = PRISON AND R75 =1] In the 30 days before you were admitted to any facility to serve time on your current sentence, were you receiving any medical treatment other than prescription medicine for your post-traumatic stress disorder or PTSD?


1 Yes

2 No

DK/REF


R78 [IF FACILITY = JAIL AND R75 = 2] Since you were admitted to this facility, have you been told by a doctor, nurse, or other health care provider that you had post-traumatic stress disorder or PTSD?


[IF FACILITY = PRISON AND R75 = 2] Since you were admitted to any facility to serve time on your current sentence, have you been told by a doctor, nurse, or other health care provider that you had post-traumatic stress disorder or PTSD?


1 Yes

2 No

DK/REF


R79 [IF FACILITY = JAIL AND (R75 =1 OR R78 =1)] Since you were admitted to this facility, have you taken any prescription medicine for your post-traumatic stress disorder or PTSD?


[IF FACILITY = PRISON AND (R75 =1 OR R78 =1)] Since you were admitted to any facility to serve time on your current sentence, have you taken any prescription medicine for your post-traumatic stress disorder or PTSD?


1 Yes

2 No

DK/REF


R80 [IF FACILITY = JAIL AND (R75 =1 OR R78 =1)] Since you were admitted to this facility, have you received any medical treatment other than prescription medicine for your post-traumatic stress disorder or PTSD?


[IF FACILITY = PRISON AND (R75 =1 OR R78 =1)] Since you were admitted to any facility to serve time on your current sentence, have you received any medical treatment other than prescription medicine for your post-traumatic stress disorder or PTSD?


1 Yes

2 No

DK/REF


R81 [IF FACILITY = JAIL AND R78 = 1 AND R79 = 1] How soon after you were told that you had post-traumatic stress disorder or PTSD did you start taking prescription medicine at this facility for post-traumatic stress disorder or PTSD?


[IF FACILITY = PRISON AND R78 = 1 AND R79 = 1] Think about when you were first told that you had post-traumatic stress disorder or PTSD after you were admitted to any facility to serve time on your current sentence. How soon after you were told did you start taking prescription medicine for your post-traumatic stress disorder or PTSD?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


R82 [IF FACILITY = JAIL AND R78 = 1 AND R80 =1] How soon after you were told that you had post-traumatic stress disorder or PTSD did you start receiving any medical treatment other than prescription medicine at this facility for post-traumatic stress disorder or PTSD?


[IF FACILITY = PRISON AND R78 =1 AND R80 = 1] Think about when you were first told that you had post-traumatic stress disorder or PTSD after you were admitted to any facility to serve time on your current sentence. How soon after you were told did you start receiving any medical treatment other than prescription medicine for your post-traumatic stress disorder or PTSD?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


R83 [IF FACILITY = JAIL AND R75 = 1 AND R79 = 1] How soon after you were admitted to this facility did you start taking prescription medicine for your post-traumatic stress disorder or PTSD?


[IF FACILITY = PRISON AND R75 = 1 AND R79 = 1] How soon after you were admitted to any facility to serve time on your current sentence did you start taking prescription medicine for your post-traumatic stress disorder or PTSD?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


R84 [IF FACILITY = JAIL AND R75 = 1 AND R80 = 1] How soon after you were admitted to this facility did you start receiving any medical treatment other than prescription medicine for your post-traumatic stress disorder or PTSD?


[IF FACILITY = PRISON AND R75 = 1 AND R80 = 1] How soon after you were admitted to any facility to serve time on your current sentence did you start receiving any medical treatment other than prescription medicine for your post-traumatic stress disorder or PTSD?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


R85 [IF R24d = 1] Are you currently taking prescription medicine for your post-traumatic stress disorder or PTSD?


1 Yes

2 No

DK/REF


R86 [IF R24d = 1] Are you currently receiving any medical treatment other than prescription medicine for your post-traumatic stress disorder or PTSD?


1 Yes

2 No

DK/REF


R87 [IF R85 = 2] Why aren’t you currently taking prescription medicine for your post-traumatic stress disorder or PTSD?

Yes

No

R87a. You have not seen a doctor to get the medicine

1

2

R87b. The doctor at the facility doesn’t think you need medicine

1

2

R87c. You don’t like taking the medicine

1

2

R87d. You don’t think you need the medicine

1

2

R87e. The facility is not willing to give the medicine to you

1

2

R87f. You would have to be transferred to a different facility to receive the medicine

1

2

R87g. You don’t currently have post-traumatic stress disorder or PTSD

1

2

R87h. Some other reason

1

2


R88 [IF FACILITY TYPE = JAIL AND R24e = 1] At the time you were admitted to this facility, did you have an anxiety disorder such as panic disorder?


[IF FACILITY TYPE = PRISON AND R24e = 1] At the time you were admitted to any facility to serve time on your current sentence, did you have an anxiety disorder such as panic disorder?


1 Yes

2 No

DK/REF


R89 [IF FACILITY TYPE = JAIL AND R88 = 1] In the 30 days before you were admitted to this facility, were you taking any prescription medicine for your anxiety disorder?


[IF FACILITY TYPE = PRISON AND R88 =1] In the 30 days before you were admitted to any facility to serve time on your current sentence, were you taking any prescription medicine for your anxiety disorder?


1 Yes

2 No

DK/REF


R90 [IF FACILITY TYPE = JAIL AND R88 = 1] In the 30 days before you were admitted to this facility, were you receiving any medical treatment other than prescription medicine for your anxiety disorder?


[IF FACILITY TYPE = PRISON AND R88 =1] In the 30 days before you were admitted to any facility to serve time on your current sentence, were you receiving any medical treatment other than prescription medicine for your anxiety disorder?


1 Yes

2 No

DK/REF


R91 [IF FACILITY = JAIL AND R88 = 2] Since you were admitted to this facility, have you been told by a doctor, nurse, or other health care provider that you had an anxiety disorder such as panic disorder?


[IF FACILITY = PRISON AND R88 = 2] Since you were admitted to any facility to serve time on your current sentence, have you been told by a doctor, nurse, or other health care provider that you had an anxiety disorder such as panic disorder?


1 Yes

2 No

DK/REF


R92 [IF FACILITY = JAIL AND (R88 =1 OR R91 =1)] Since you were admitted to this facility, have you taken any prescription medicine for your anxiety disorder?


[IF FACILITY = PRISON AND (R88 =1 OR R91 =1)] Since you were admitted to any facility to serve time on your current sentence, have you taken any prescription medicine for your anxiety disorder?


1 Yes

2 No

DK/REF


R93 [IF FACILITY = JAIL AND (R88 =1 OR R91 =1)] Since you were admitted to this facility, have you received any medical treatment other than prescription medicine for your anxiety disorder?


[IF FACILITY = PRISON AND (R88 =1 OR R91 =1)] Since you were admitted to any facility to serve time on your current sentence, have you received any medical treatment other than prescription medicine for your anxiety disorder?


1 Yes

2 No

DK/REF


R94 [IF FACILITY = JAIL AND R91 = 1 AND R92 = 1] How soon after you were told that you had an anxiety disorder did you start taking prescription medicine at this facility for your anxiety disorder?


[IF FACILITY = PRISON AND R91 = 1 AND R92 = 1] Think about when you were first told that you had an anxiety disorder after you were admitted to any facility to serve time on your current sentence. How soon after you were told did you start taking prescription medicine for your anxiety disorder?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


R95 [IF FACILITY = JAIL AND R91 = 1 AND R93 =1] How soon after you were told that you had an anxiety disorder did you start receiving any medical treatment other than prescription medicine at this facility for your anxiety disorder?


[IF FACILITY = PRISON AND R91 =1 AND R93 = 1] Think about when you were first told that you had an anxiety disorder after you were admitted to any facility to serve time on your current sentence. How soon after you were told did you start receiving any medical treatment other than prescription medicine for your anxiety disorder?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


R96 [IF FACILITY = JAIL AND R88 = 1 AND R92 = 1] How soon after you were admitted to this facility did you start taking prescription medicine for your anxiety disorder?


[IF FACILITY = PRISON AND R88 = 1 AND R91 = 1] How soon after you were admitted to any facility to serve time on your current sentence did you start taking prescription medicine for your anxiety disorder?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


R97 [IF FACILITY = JAIL AND R88 = 1 AND R93 = 1] How soon after you were admitted to this facility did you start receiving any medical treatment other than prescription medicine for your anxiety disorder?


[IF FACILITY = PRISON AND R88 = 1 AND R93 = 1] How soon after you were admitted to any facility to serve time on your current sentence did you start receiving any medical treatment other than prescription medicine for your anxiety disorder?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


R98 [IF R24e = 1] Are you currently taking prescription medicine for your anxiety disorder?


1 Yes

2 No

DK/REF


R99 [IF R24e = 1] Are you currently receiving any medical treatment other than prescription medicine for your anxiety disorder?


1 Yes

2 No

DK/REF


R100 [IF R98 = 2] Why aren’t you currently taking prescription medicine for your anxiety disorder?

Yes

No

R100a. You have not seen a doctor to get the medicine

1

2

R100b. The doctor at the facility doesn’t think you need medicine

1

2

R100c. You don’t like taking the medicine

1

2

R100d. You don’t think you need the medicine

1

2

R100e. The facility is not willing to give the medicine to you

1

2

R100f. You would have to be transferred to a different facility to receive the medicine

1

2

R100g. You don’t currently have an anxiety disorder

1

2

R100h. Some other reason

1

2


R101 [IF FACILITY TYPE = JAIL AND R24f = 1] At the time you were admitted to this facility, did you have a personality disorder such as antisocial or borderline personality?


[IF FACILITY TYPE = PRISON AND R24f = 1] At the time you were admitted to any facility to serve time on your current sentence, did you have a personality disorder such as antisocial or borderline personality?


1 Yes

2 No

DK/REF


R102 [IF FACILITY TYPE = JAIL AND R101 = 1] In the 30 days before you were admitted to this facility, were you taking any prescription medicine for your personality disorder?


[IF FACILITY TYPE = PRISON AND R101 =1] In the 30 days before you were admitted to any facility to serve time on your current sentence, were you taking any prescription medicine for your personality disorder?


1 Yes

2 No

DK/REF


R103 [IF FACILITY TYPE = JAIL AND R101 = 1] In the 30 days before you were admitted to this facility, were you receiving any medical treatment other than prescription medicine for your personality disorder?


[IF FACILITY TYPE = PRISON AND R101 =1] In the 30 days before you were admitted to any facility to serve time on your current sentence, were you receiving any medical treatment other than prescription medicine for your personality disorder?


1 Yes

2 No

DK/REF


R104 [IF FACILITY = JAIL AND R101 = 2] Since you were admitted to this facility, have you been told by a doctor, nurse, or other health care provider that you had a personality disorder such as antisocial or borderline personality?


[IF FACILITY = PRISON AND R101 = 2] Since you were admitted to any facility to serve time on your current sentence, have you been told by a doctor, nurse, or other health care provider that you had a personality disorder such as antisocial or borderline personality?


1 Yes

2 No

DK/REF


R105 [IF FACILITY = JAIL AND (R101 =1 OR R104 =1)] Since you were admitted to this facility, have you taken any prescription medicine for your personality disorder?


[IF FACILITY = PRISON AND (R101 =1 OR R104 =1)] Since you were admitted to any facility to serve time on your current sentence, have you taken any prescription medicine for your personality disorder?


1 Yes

2 No

DK/REF


R106 [IF FACILITY = JAIL AND (R101 =1 OR R104 =1)] Since you were admitted to this facility, have you received any medical treatment other than prescription medicine for your personality disorder?


[IF FACILITY = PRISON AND (R101 =1 OR R104 =1)] Since you were admitted to any facility to serve time on your current sentence, have you received any medical treatment other than prescription medicine for your personality disorder?


1 Yes

2 No

DK/REF


R107 [IF FACILITY = JAIL AND R104 = 1 AND R105 = 1] How soon after you were told that you had a personality disorder did you start taking prescription medicine at this facility for your personality disorder?


[IF FACILITY = PRISON AND R104 = 1 AND 105 = 1] Think about when you were first told that you had a personality ty disorder after you were admitted to any facility to serve time on your current sentence. How soon after you were told did you start taking prescription medicine for your personality disorder?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


R108 [IF FACILITY = JAIL AND R104 = 1 AND R106 =1] How soon after you were told that you had a personality disorder did you start receiving any medical treatment other than prescription medicine at this facility for your personality disorder?


[IF FACILITY = PRISON AND R104 =1 AND R106 = 1] Think about when you were first told that you had an personality disorder after you were admitted to any facility to serve time on your current sentence. How soon after you were told did you start receiving any medical treatment other than prescription medicine for your personality disorder?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


R109 [IF FACILITY = JAIL AND R101 = 1 AND R105 = 1] How soon after you were admitted to this facility did you start taking prescription medicine for your personality disorder?


[IF FACILITY = PRISON AND R101 = 1 AND R105 = 1] How soon after you were admitted to any facility to serve time on your current sentence did you start taking prescription medicine for your personality disorder?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


R110 [IF FACILITY = JAIL AND R101 = 1 AND R106 = 1] How soon after you were admitted to this facility did you start receiving any medical treatment other than prescription medicine for your personality disorder?


[IF FACILITY = PRISON AND R101 = 1 AND R106 = 1] How soon after you were admitted to any facility to serve time on your current sentence did you start receiving any medical treatment other than prescription medicine for your personality disorder?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


R111 [IF R24f = 1] Are you currently taking prescription medicine for your persoanlity disorder?


1 Yes

2 No

DK/REF


R112 [IF R24f = 1] Are you currently receiving any medical treatment other than prescription medicine for your personality disorder?


1 Yes

2 No

DK/REF


R113 [IF R111 = 2] Why aren’t you currently taking prescription medicine for your personality disorder?

Yes

No

R113a. You have not seen a doctor to get the medicine

1

2

R113b. The doctor at the facility doesn’t think you need medicine

1

2

R113c. You don’t like taking the medicine

1

2

R113d. You don’t think you need the medicine

1

2

R113e. The facility is not willing to give the medicine to you

1

2

R113f. You would have to be transferred to a different facility to receive the medicine

1

2

R113g. You don’t currently have a personality disorder

1

2

R113h. Some other reason

1

2




Section Q – Disability Status


TIME STAMP HERE


Q0 The next questions are about difficulties that you might have due to a physical, mental, or emotional problem.


Touch the NEXT button to go to the next screen.


Q1 Are you deaf or do you have serious difficulty hearing?


1 Yes

2 No

DK/REF


Q2 Are you blind or do you have serious difficulty seeing even when wearing glasses?


1 Yes

2 No

DK/REF


Q3 Because of a physical, mental, or emotional problem, do you have serious difficulty concentrating, remembering, or making decisions?


1 Yes

2 No

DK/REF


Q4 Do you have serious difficulty walking or climbing stairs?


1 Yes

2 No

DK/REF


Q5 Do you have difficulty dressing or bathing?


1 Yes

2 No

DK/REF


Q6 Because of a physical, mental, or emotional problem, do you have difficulty doing activities on your own such as going to meal time, going outside, working in or outside of this facility, going to classes, or attending programs?


1 Yes

2 No

DK/REF


Q7 [IF Q1 OR Q2 OR Q3 OR Q4 OR Q5 OR Q6 = 1] Is the difficulty you experience doing activities on your own caused by…



Yes

No

H7a. A physical problem?

1

2

H7b. A mental or emotional problem?

1

2


Section P – Medical Conditions and Care


TIME STAMP HERE


P0 [IF FACILITY TYPE = JAIL] The next questions are about your health and any health and dental care you may have received since you were admitted to this facility. Some questions may ask about prescription medicines. Prescription medicines are drugs that you take if a doctor authorizes them for you.


[IF FACILITY TYPE = PRISON] The next questions are about your health and any health care you may have received in any facility where you have been held to serve time on your current sentence. Some questions may ask about prescription medicines. Prescription medicines are drugs that you take if a doctor authorizes them for you.


Touch the NEXT button to go to the next screen.


P1 [IF FACILITY TYPE = JAIL] When you were admitted to this facility, did a staff person…


[IF FACILITY TYPE = PRISON] When you were first admitted to any facility to serve time on your current sentence, did a staff person…

Yes

No

P1a. check to see if you were sick, injured, drunk, or high?

1

2

P1b. ask you any questions about your health or medical history?

1

2

P1c. ask if you had ever thought about or tried to commit suicide?

1

2



P5 [IF FACILITY TYPE = JAIL] Since you were admitted to this facility, have you been injured in an accident, such as slipping or falling while at work or while playing sports?


[IF FACILITY TYPE = PRISON] Since you were admitted to any facility to serve time on your current sentence, have you been injured in an accident, such as slipping or falling while at work or while playing sports?


1 Yes

2 No

DK/REF


P6 [IF FACILITY TYPE = JAIL AND P5 = 1] Since you were admitted to this facility, what types of injuries have you received as a result of an accident?


[IF FACILITY TYPE = PRISON AND P5 = 1] Since you were admitted to any facility to serve time on your current sentence what types of injuries have you received as a result of an accident?

Yes

No

P6a. You received broken bones

1

2

P6b. Your teeth were chipped or knocked out

1

2

P6c. You received internal injuries

1

2

P6d. You were knocked unconscious

1

2

P6e. You received bruises, a black eye, sprains, cuts, scratches, swelling, welts, or burns

1

2



P7 [IF P6a = 1 OR P6b = 1 OR P6c = 1 OR P6d = 1 OR P6e = 1] Did you see a doctor, nurse, or other health care provider for any of your injuries?


1 Yes

2 No

DK/REF


P8 [IF FACILITY TYPE = JAIL] Since you were admitted to this facility, have you had any type of surgery?


[IF FACILITY TYPE = PRISON] Since you were admitted to any facility to serve time on your current sentence, have you had any type of surgery?


1 Yes

2 No

DK/REF


P9 [IF FACILITY TYPE = JAIL] Since you were admitted to this facility, have you had any problems with your teeth or gums?


[IF FACILITY TYPE = PRISON] Since you were admitted to any facility to serve time on your current sentence, have you had any problems with your teeth or gums?


1 Yes

2 No

DK/REF

P10 [If P9 = 1], Did you see a dentist, doctor, nurse, or other health care provider for any of these problems with your teeth or gums?


1 Yes

2 No

DK/REF


P11 [IF FACILITY TYPE = JAIL] Since you were admitted to this facility, have you seen a doctor, nurse, or other health care provider for any reason other than those already mentioned?


[IF FACILITY TYPE = PRISON] Since you were admitted to any facility to serve time on your current sentence, have you seen a doctor, nurse, or other health care provider for any reason other than those already mentioned?


1 Yes

2 No

DK/REF


P12 [IF FACILITY TYPE = JAIL] How satisfied are you with the health care you have received since you were admitted to this facility?


[IF FACILITY TYPE = PRISON] How satisfied are you with the health care you have received at any facility where you have been held to serve time on your current sentence?


1 Very satisfied

2 Somewhat satisfied

3 Not satisfied at all

DK/REF


P13 [IF FACILITY = JAIL] Compared to the health care you were receiving during the 12 months before you were admitted to this facility, how would you rate the quality of health care you have received at this facility?


[IF FACILITY =PRISON] Compared to the health care you were receiving during the 12 months before you were admitted to any facility to serve time on your current sentence, how would you rate the quality of health care you have received at this facility?


1 Better

2 About the same

3 Worse

DK/REF


P14 [IF FACILITY TYPE = JAIL] The next questions are about medical tests you may have had since you were admitted to this facility.


[IF FACILITY TYPE = PRISON] The next questions are about medical tests you may have had since you were admitted to any facility to serve time on your current sentence.


P15 [IF FACILITY TYPE = JAIL] Since you were admitted to this facility, has anyone pricked your skin to test you for tuberculosis or TB?


[IF FACILITY TYPE = PRISON] Since you were admitted to any facility to serve time on your current sentence, has anyone pricked your skin to test you for tuberculosis or TB?


1 Yes

2 No

DK/REF


P16 [IF P15 = 1] What was the result of the last tuberculosis (TB) test you had?


1 Positive – you have tuberculosis (TB)

2 Negative – you do not have tuberculosis (TB)

3 Your results are not available yet

4 You were never told the result

DK/REF


P17 [IF P16 = 1] Were you given medicine to take because of your positive tuberculosis or TB skin test?


1 Yes

2 No

DK/REF

P18 [IF P15 NE 1] Have you ever been told that you have tuberculosis or TB?


1 Yes

2 No

DK/REF


P19 [IF FACILITY TYPE = JAIL] Since you were admitted to this facility, have you had your blood tested for any reason?


[IF FACILITY TYPE = PRISON] Since you were admitted to any facility to serve time on your current sentence, have you had your blood tested for any reason?


1 Yes

2 No

DK/REF


P20 [IF FACILITY TYPE = JAIL AND P19 = 1] Since you were admitted to this facility, have you had your blood tested for HIV – the virus that causes AIDS?


[IF FACILITY TYPE = PRISON AND P19 = 1] Since you were admitted to any facility to serve time on your current sentence,, have you had your blood tested for HIV – the virus that causes AIDS?


1 Yes

2 No

DK/REF


P21 [IF P20 = 1] What was the result of the most recent HIV test you had?


1 Positive, you are infected with HIV – the virus that causes AIDS

2 Negative you are not infected with HIV – the virus that causes AIDS

3 Your results are not available yet

4 You were never told the result

DK/REF


P22 [IF P20 NE 1] Have you ever been tested for HIV – the virus that causes AIDS?


1 Yes

2 No

DK/REF



P23 [IF P22 = 1] What was the result of the most recent HIV test you had?


1 Positive, you are infected with HIV – the virus that causes AIDS

2 Negative, you are not infected with the virus that causes AIDS

3 Your results are not available yet

4 You were never told the result

DK/REF


P24 [IF P21 OR P23 = 1] Are you currently taking any medicine or receiving treatment for HIV – the virus that causes AIDS?


1 Yes

2 No

DK/REF



P25 [IF {FACILITY TYPE = JAIL AND P19 = 1] Since you were admitted to this facility, have you been tested for Hepatitis B?


[IF {FACILITY TYPE = PRISON AND P19 = 1}] Since you were admitted to any facility to serve time on your current sentence, have you been tested for Hepatitis B?


1 Yes

2 No

DK/REF

P26 [IF P25 = 1] What was the result of the most recent Hepatitis B test you had?


1 Positive, you are infected with Hepatitis B

2 Negative, you are not infected with Hepatitis B

3 Your results are not available yet

4 You were never told the result

DK/REF


P27 [IF P25 NE 1] Have you ever been told that you have Hepatitis B?


1 Yes

2 No

DK/REF



P28 [IF {FACILITY TYPE = JAIL AND P19 = 1] Since you were admitted to this facility, have you been tested for Hepatitis C?


[IF {FACILITY TYPE = PRISON AND P19 = 1] Since you were admitted to any facility to serve time on your current sentence, have you been tested for Hepatitis C?


1 Yes

2 No

DK/REF


P29 [IF P28 = 1] What was the result of the most recent Hepatitis C test you had?


1 Positive, you are infected with Hepatitis C

2 Negative, you are not infected with Hepatitis C

3 Your results are not available yet

4 You were never told the result

DK/REF


P30 [IF P28 NE 1] Have you ever been told that you have Hepatitis C?


1 Yes

2 No

DK/REF


P31 [IF {FACILITY TYPE = JAIL AND P19 = 1] Since you were admitted to this facility, have you been tested for any sexually transmitted disease other than HIV, Hepatitis B, and Hepatitis C?


[IF {FACILITY TYPE = PRISON AND P19 = 1}] Since you were admitted to any facility to serve time on your current sentence, have you been tested for any sexually transmitted disease other than HIV, Hepatitis B, and Hepatitis C?


1 Yes

2 No

DK/REF

P32 [IF P31 = 1] What was the result of the most recent sexually transmitted disease test you had?


1 Positive, a sexually transmitted disease infection was found

2 Negative, no sexually transmitted disease infection was found

3 Your results are not available yet

4 You were never told the result

DK/REF


P33 [IF P31 NE 1] Have you ever been told that you had any sexually transmitted disease other than HIV, Hepatitis B, and Hepatitis C?


1 Yes

2 No

DK/REF


P34 These next questions are about specific medical problems you may have had in the past or have currently.


Touch the NEXT button to go to the next screen.


P35 Has a doctor, nurse, or other health care provider ever told you that you had…

Yes

No

P35a. Any type of cancer?

1

2

P35b. High blood pressure or hypertension?

1

2

P35c. A stroke?

1

2

P35d. Diabetes or high blood sugar?

1

2

P35e. A problem with your heart?

1

2

P35f. A problem with your kidneys?

1

2

P35g. Arthritis or rheumatism?

1

2

P35h. Asthma?

1

2

P35i. Cirrhosis of the liver?

1

2


P36 Have you ever been paralyzed or unable to move your legs, arms, or other areas of your body? Please do not include times when you may have been held down, tied up, or medicated.


1 Yes

2 No

DK/REF


P37 Have you ever been knocked unconscious?


1 Yes

2 No

DK/REF


P38 [IF P35a = 1] What kind of cancer did a doctor, nurse, or other health care provider tell you that you had?

Yes

No

P38a. [GENDER = F] Breast cancer

1

2

P38b. [GENDER = F] Cervical cancer

1

2

P38c. Colon cancer

1

2

P38d. Leukemia

1

2

P38e. Lung cancer

1

2

P38f. [GENDER = F] Ovarian cancer

1

2

P38g. [GENDER = M] Prostate cancer

1

2

P38h. Skin cancer or melanoma

1

2

P38i. [GENDER = M] Testicular cancer

1

2

P38j. [GENDER = F] Uterine cancer

1

2

P38k. Some other kind of cancer

1

2



P39 [IF P35e = 1] What type of heart problems did a doctor, nurse, or other health care provider tell you that you had?

Yes

No

P39a. Angina or angina pectoris

1

2

P39b. An irregular heart beat, also known as arrhythmia

1

2

P39c. Arteriosclerosis or hardening of the arteries

1

2

P39d. A heart attack or myocardial infarction

1

2

P39e. Coronary, congenital, or rheumatic heart disease

1

2

P39f. A heart murmur or other heart valve damage

1

2

P39g. Tachycardia or a rapid heart beat

1

2

P39h. Some other kind of heart problem

1

2



P40 [IF P35a = 1 OR P35b = 1 OR P35c = 1 OR P35d = 1 OR P35e = 1 OR P35f = 1 OR P35g = 1 OR P35h = 1 OR P35i = 1] Has a doctor, nurse, or other health care provider told you that you currently have…

NOTE TO PROGRAMMERS: CAN THIS SCREEN FILL WITH ONLY THOSE DISEASES THE R ENDORSED IN P35?

Yes

No

P40a. [IF P35a = 1] Any type of cancer?

1

2

P40b. [IF P35b = 1] High blood pressure or hypertension?

1

2

P40c. [IF P35c = 1] Problems caused by a stroke?

1

2

P40d. [IF P35d = 1] Diabetes or high blood sugar?

1

2

P40e. [IF P35e = 1] A problem with your heart?

1

2

P40f. [IF P35f = 1] A problem with your kidneys?

1

2

P40g. [IF P35g = 1] Arthritis or rheumatism?

1

2

P40h. [IF P35h = 1] Asthma?

1

2

P40i. [IF P35i = 1] Cirrhosis of the liver?

1

2



P41 [IF P36 = 1] Are you currently paralyzed or unable to move parts of your body?


1 Yes

2 No

DK/REF


P42 [IF P37 = 1] Do you currently have problems because you were knocked unconscious at some time in the past?


1 Yes

2 No

DK/REF


P43 [IF P40a = 1] What kind of cancer do you currently have?

Yes

No

P43a. [GENDER = F] Breast cancer

1

2

P43b. [GENDER = F] Cervical cancer

1

2

P43c. Colon cancer

1

2

P43d. Leukemia

1

2

P43e. Lung cancer

1

2

P43f. [GENDER = F] Ovarian cancer

1

2

P43g. [GENDER = M] Prostate cancer

1

2

P43h. Skin cancer or melanoma

1

2

P43i. [GENDER = M] Testicular cancer

1

2

P43j. [GENDER = F] Uterine cancer

1

2

P43k. Some other kind of cancer

1

2



P44 [IF P40e = 1] What type of heart problems did a doctor, nurse, or other health care provider tell you that you currently have?

Yes

No

P44a. Angina or angina pectoris

1

2

P44b. An irregular heart beat, also known as arrhythmia

1

2

P44c. Arteriosclerosis or hardening of the arteries

1

2

P44d. A heart attack or myocardial infarction

1

2

P44e. Coronary, congenital, or rheumatic heart disease

1

2

P44f. A heart murmur or other heart valve damage

1

2

P44g. Tachycardia or a rapid heart beat

1

2

P44h. Some other kind of heart problem

1

2



P45 [IF FACILITY TYPE = JAIL AND P35a = 1] At the time you were admitted to this facility, did you have cancer?


[IF FACILITY TYPE = PRISON AND P35a = 1] At the time you were admitted to any facility to serve time on your current sentence, did you have cancer?


1 Yes

2 No

DK/REF


P46 [IF FACILITY TYPE = JAIL AND P45 = 1] In the 30 days before you were admitted to this facility, were you taking any prescription medicine for your cancer?


[IF FACILITY TYPE = PRISON AND P45 =1] In the 30 days before you were admitted to any facility to serve time on your current sentence, were you taking any prescription medicine for your cancer?


1 Yes

2 No

DK/REF


P47 [IF FACILITY TYPE = JAIL AND P45 = 1] In the 30 days before you were admitted to this facility, were you receiving any medical treatment other than prescription medicine for your cancer?


[IF FACILITY TYPE = PRISON AND P45 =1] In the 30 days before you were admitted to any facility to serve time on your current sentence, were you receiving any medical treatment other than prescription medicine for your cancer?


1 Yes

2 No

DK/REF


P48 [IF FACILITY = JAIL AND P45 = 2] Since you were admitted to this facility, have you been told by a doctor, nurse, or other health care provider that you had cancer?


[IF FACILITY = PRISON AND P45 = 2] Since you were admitted to any facility to serve time on your current sentence, have you been told by a doctor, nurse, or other health care provider that you had cancer?


1 Yes

2 No

DK/REF


P49 [IF FACILITY = JAIL AND (P45 =1 OR P48 =1)] Since you were admitted to this facility, have you taken any prescription medicine for your cancer?


[IF FACILITY = PRISON AND (P45 =1 OR P48 =1)] Since you were admitted to any facility to serve time on your current sentence, have you taken any prescription medicine for your cancer?


1 Yes

2 No

DK/REF


P50 [IF FACILITY = JAIL AND (P45 =1 OR P48 =1)] Since you were admitted to this facility, have you received any medical treatment other than prescription medicine for your cancer?


[IF FACILITY = PRISON AND (P45 =1 OR P48 =1)] Since you were admitted to any facility to serve time on your current sentence, have you received any medical treatment other than prescription medicine for your cancer?


1 Yes

2 No

DK/REF



P51 [IF FACILITY = JAIL AND P48 = 1 AND P49 = 1], How soon after you were told that you had cancer did you start taking prescription medicine at this facility?


[IF FACILITY = PRISON AND P48 = 1 AND P49 = 1] Think about when you were first told that you had cancer after you were admitted to any facility to serve time on your current sentence. How soon after you were told did you start taking prescription medicine for your cancer?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


P52 [IF FACILITY = JAIL AND P48 = 1 AND P50 =1] How soon after you were told that you had cancer did you start receiving any medical treatment other than prescription medicine at this facility?


[IF FACILITY = PRISON AND P48 = 1 AND P50 = 1] Think about when you were first told that you had cancer after you were admitted to any facility to serve time on your current sentence. How soon after you were told did you start receiving any medical treatment other than prescription medicine for your cancer?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


P53 [IF FACILITY = JAIL AND P45 = 1 AND P49 = 1] How soon after you were admitted to this facility did you start taking prescription medicine for your cancer?


[IF FACILITY = PRISON AND P45 = 1 AND P49 = 1] How soon after you were admitted to any facility to serve time on your current sentence did you start taking prescription medicine for your cancer?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


P54 [IF FACILITY = JAIL AND P45 = 1 AND P50 = 1] How soon after you were admitted to this facility did you start receiving any medical treatment other than prescription medicine for your cancer?


[IF FACILITY = PRISON AND P45 = 1 AND P50 = 1] How soon after you were admitted to any facility to serve time on your current sentence did you start receiving any medical treatment other than prescription medicine for your cancer?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


P55 [IF P40a = 1] Are you currently taking prescription medicine for your cancer?


1 Yes

2 No

DK/REF


P56 [IF P40a = 1] Are you currently receiving any medical treatment other than prescription medicine for your cancer?


1 Yes

2 No

DK/REF


P57 [IF P55 = 2] Why aren’t you currently taking prescription medicine for your cancer?

Yes

No

P57a. You have not seen a doctor to get the medicine

1

2

P57b. The doctor at the facility doesn’t think you need medicine

1

2

P57c. You don’t like taking the medicine

1

2

P57d. You don’t think you need the medicine

1

2

P57e. The facility is not willing to give the medicine to you

1

2

P57f. You would have to be transferred to a different facility to receive the medicine

1

2

P57g. You don’t currently have cancer

1

2

P57h. Some other reason

1

2


P58 [IF FACILITY TYPE = JAIL AND P35b = 1] At the time you were admitted to this facility, did you have high blood pressure or hypertension?


[IF FACILITY TYPE = PRISON AND P35b = 1] At the time you were admitted to any facility to serve time on your current sentence, did you have high blood pressure or hypertension?


1 Yes

2 No

DK/REF


P59 [IF FACILITY TYPE = JAIL AND P58 = 1] In the 30 days before you were admitted to this facility, were you taking any prescription medicine for your high blood pressure or hypertension?


[IF FACILITY TYPE = PRISON AND P58 =1] In the 30 days before you were admitted to any facility to serve time on your current sentence, were you taking any prescription medicine for your high blood pressure or hypertension?


1 Yes

2 No

DK/REF


P60 [IF FACILITY TYPE = JAIL AND P58 = 1] In the 30 days before you were admitted to this facility, were you receiving any medical treatment other than prescription medicine for your high blood pressure or hypertension?


[IF FACILITY TYPE = PRISON AND P58 =1] In the 30 days before you were admitted to any facility to serve time on your current sentence, were you receiving any medical treatment other than prescription medicine for your high blood pressure or hypertension?


1 Yes

2 No

DK/REF


P61 [IF FACILITY = JAIL AND P58 = 2] Since you were admitted to this facility, have you been told by a doctor, nurse, or other health care provider that you had high blood pressure or hypertension?


[IF FACILITY = PRISON AND P58 = 2] Since you were admitted to any facility to serve time on your current sentence, have you been told by a doctor, nurse, or other health care provider that you had high blood pressure or hypertension?


1 Yes

2 No

DK/REF


P62 [IF FACILITY = JAIL AND (P58 =1 OR P61 =1)] Since you were admitted to this facility, have you taken any prescription medicine for your high blood pressure or hypertension?


[IF FACILITY = PRISON AND (P58 =1 OR P61 =1)] Since you were admitted to any facility to serve time on your current sentence, have you taken any prescription medicine for your high blood pressure or hypertension?


1 Yes

2 No

DK/REF


P63 [IF FACILITY = JAIL AND (P58 =1 OR P61 =1)] Since you were admitted to this facility, have you received any medical treatment other than prescription medicine for your high blood pressure or hypertension?


[IF FACILITY = PRISON AND (P58 =1 OR P61 =1)] Since you were admitted to any facility to serve time on your current sentence, have you received any medical treatment other than prescription medicine for your high blood pressure or hypertension?


1 Yes

2 No

DK/REF



P64 [IF FACILITY = JAIL AND P61 = 1 AND P62 = 1], How soon after you were told that you had high blood pressure or hypertension did you start taking prescription medicine at this facility?


[IF FACILITY = PRISON AND P61 = 1 AND P62 = 1] Think about when you were first told that you had high blood pressure or hypertension after you were admitted to any facility to serve time on your current sentence. How soon after you were told did you start taking prescription medicine for your high blood pressure or hypertension?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


P65 [IF FACILITY = JAIL AND P61 = 1 AND P63 =1] How soon after you were told that you had high blood pressure or hypertension did you start receiving any medical treatment other than prescription medicine at this facility?


[IF FACILITY = PRISON AND P61 =1 AND P63 = 1] Think about when you were first told that you had high blood pressure or hypertension after you were admitted to any facility to serve time on your current sentence. How soon after you were told did you start receiving any medical treatment other than prescription medicine for your high blood pressure or hypertension?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


P66 [IF FACILITY = JAIL AND P58 = 1 AND P62 = 1] How soon after you were admitted to this facility did you start taking prescription medicine for your high blood pressure or hypertension?


[IF FACILITY = PRISON AND P58 = 1 AND P62 = 1] How soon after you were admitted to any facility to serve time on your current sentence did you start taking prescription medicine for your high blood pressure or hypertension?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


P67 [IF FACILITY = JAIL AND P58 = 1 AND P63 = 1] How soon after you were admitted to this facility did you start receiving any medical treatment other than prescription medicine for your high blood pressure or hypertension?


[IF FACILITY = PRISON AND P58 = 1 AND P63 = 1] How soon after you were admitted to any facility to serve time on your current sentence did you start receiving any medical treatment other than prescription medicine for your high blood pressure or hypertension?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


P68 [IF P40b = 1] Are you currently taking prescription medicine for your high blood pressure or hypertension?


1 Yes

2 No

DK/REF


P69 [IF P40b = 1] Are you currently receiving any medical treatment other than prescription medicine for your high blood pressure or hypertension?


1 Yes

2 No

DK/REF


P70 [IF P68 = 2] Why aren’t you currently taking prescription medicine for your high blood pressure or hypertension?

Yes

No

P70a. You have not seen a doctor to get the medicine

1

2

P70b. The doctor at the facility doesn’t think you need medicine

1

2

P70c. You don’t like taking the medicine

1

2

P70d. You don’t think you need the medicine

1

2

P70e. The facility is not willing to give the medicine to you

1

2

P70f. You would have to be transferred to a different facility to receive the medicine

1

2

P70g. You don’t currently have high blood pressure or hypertension

1

2

P70h. Some other reason

1

2


P175 [IF FACILITY TYPE = JAIL AND P35c = 1] At the time you were admitted to this facility, did you have problems caused by a stroke?


[IF FACILITY TYPE = PRISON AND P35c = 1] At the time you were admitted to any facility to serve time on your current sentence, did you have problems caused by a stroke?


1 Yes

2 No

DK/REF


P176 [IF FACILITY TYPE = JAIL AND P175 = 1] In the 30 days before you were admitted to this facility, were you taking any prescription medicine for problems caused by a stroke?


[IF FACILITY TYPE = PRISON AND P175 =1] In the 30 days before you were admitted to any facility to serve time on your current sentence, were you taking any prescription medicine for problems caused by a stroke?


1 Yes

2 No

DK/REF


P177 [IF FACILITY TYPE = JAIL AND P175 = 1] In the 30 days before you were admitted to this facility, were you receiving any medical treatment other than prescription medicine for problems caused by a stroke?


[IF FACILITY TYPE = PRISON AND P175 =1] In the 30 days before you were admitted to any facility to serve time on your current sentence, were you receiving any medical treatment other than prescription medicine for problems caused by a stroke?


1 Yes

2 No

DK/REF


P178 [IF FACILITY = JAIL AND P175 = 2] Since you were admitted to this facility, have you been told by a doctor, nurse, or other health care provider that you had problems caused by a stroke?


[IF FACILITY = PRISON AND P175 = 2] Since you were admitted to any facility to serve time on your current sentence, have you been told by a doctor, nurse, or other health care provider that you had problems caused by a stroke?


1 Yes

2 No

DK/REF


P179 [IF FACILITY = JAIL AND (P175 =1 OR P178 =1)] Since you were admitted to this facility, have you taken any prescription medicine for problems caused by a stroke?


[IF FACILITY = PRISON AND (P175 =1 OR P178 =1)] Since you were admitted to any facility to serve time on your current sentence, have you taken any prescription medicine for problems caused by a stroke?


1 Yes

2 No

DK/REF


P180 [IF FACILITY = JAIL AND (P175 =1 OR P178 =1)] Since you were admitted to this facility, have you received any medical treatment other than prescription medicine for problems caused by a stroke?


[IF FACILITY = PRISON AND (P175 =1 OR P178 =1)] Since you were admitted to any facility to serve time on your current sentence, have you received any medical treatment other than prescription medicine for problems caused by a stroke?


1 Yes

2 No

DK/REF



P181 [IF FACILITY = JAIL AND P178 = 1 AND P179 = 1], How soon after you were told that you had problems caused by a stroke did you start taking prescription medicine at this facility?


[IF FACILITY = PRISON AND P178 = 1 AND P179 = 1] Think about when you were first told that you had problems caused by a stroke after you were admitted to any facility to serve time on your current sentence. How soon after you were told did you start taking prescription medicine for problems caused by a stroke?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


P182 [IF FACILITY = JAIL AND P178 = 1 AND P180 =1] How soon after you were told that you had problems caused by a stroke did you start receiving any medical treatment other than prescription medicine at this facility?


[IF FACILITY = PRISON AND P178 =1 AND P180 = 1] Think about when you were first told that you had problems caused by a stroke after you were admitted to any facility to serve time on your current sentence. How soon after you were told did you start receiving any medical treatment other than prescription medicine for problems caused by a stroke?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


P183 [IF FACILITY = JAIL AND P175 = 1 AND P179 = 1] How soon after you were admitted to this facility did you start taking prescription medicine for problems caused by a stroke?


[IF FACILITY = PRISON AND P175 = 1 AND P179 = 1] How soon after you were admitted to any facility to serve time on your current sentence did you start taking prescription medicine for problems caused by a stroke?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


P184 [IF FACILITY = JAIL AND P175 = 1 AND P180 = 1] How soon after you were admitted to this facility did you start receiving any medical treatment other than prescription medicine for problems caused by a stroke?


[IF FACILITY = PRISON AND P175 = 1 AND P180 = 1] How soon after you were admitted to any facility to serve time on your current sentence did you start receiving any medical treatment other than prescription medicine for problems caused by a stroke?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


P185 [IF P40c= 1] Are you currently taking prescription medicine for problems caused by a stroke?


1 Yes

2 No

DK/REF


P186 [IF P40c = 1] Are you currently receiving any medical treatment other than prescription medicine for problems caused by a stroke?


1 Yes

2 No

DK/REF


P187 [IF P185 = 2] Why aren’t you currently taking prescription medicine for problems caused by a stroke?

Yes

No

P187a. You have not seen a doctor to get the medicine

1

2

P187b. The doctor at the facility doesn’t think you need medicine

1

2

P187c. You don’t like taking the medicine

1

2

P187d. You don’t think you need the medicine

1

2

P187e. The facility is not willing to give the medicine to you

1

2

P187f. You would have to be transferred to a different facility to receive the medicine

1

2

P187g. You don’t currently have problems caused by a stroke

1

2

P187h. Some other reason

1

2


P71 [IF FACILITY TYPE = JAIL AND P35d = 1] At the time you were admitted to this facility, did you have diabetes or high blood sugar?


[IF FACILITY TYPE = PRISON AND P35d = 1] At the time you were admitted to any facility to serve time on your current sentence, did you have diabetes or high blood sugar?


1 Yes

2 No

DK/REF


P72 [IF FACILITY TYPE = JAIL AND P71 = 1] In the 30 days before you were admitted to this facility, were you taking any prescription medicine for your diabetes or high blood sugar?


[IF FACILITY TYPE = PRISON AND P71 =1] In the 30 days before you were admitted to any facility to serve time on your current sentence, were you taking any prescription medicine for your diabetes or high blood sugar?


1 Yes

2 No

DK/REF


P73 [IF FACILITY TYPE = JAIL AND P71 = 1] In the 30 days before you were admitted to this facility, were you receiving any medical treatment other than prescription medicine for your diabetes or high blood sugar?


[IF FACILITY TYPE = PRISON AND P71 =1] In the 30 days before you were admitted to any facility to serve time on your current sentence, were you receiving any medical treatment other than prescription medicine for your diabetes or high blood sugar?


1 Yes

2 No

DK/REF


P74 [IF FACILITY = JAIL AND P71 = 2] Since you were admitted to this facility, have you been told by a doctor, nurse, or other health care provider that you had diabetes or high blood sugar?


[IF FACILITY = PRISON AND P71 = 2] Since you were admitted to any facility to serve time on your current sentence, have you been told by a doctor, nurse, or other health care provider that you had diabetes or high blood sugar?


1 Yes

2 No

DK/REF


P75 [IF FACILITY = JAIL AND (P71 =1 OR P74 =1)] Since you were admitted to this facility, have you taken any prescription medicine for your diabetes or high blood sugar?


[IF FACILITY = PRISON AND (P71 =1 OR P74 =1)] Since you were admitted to any facility to serve time on your current sentence, have you taken any prescription medicine for your diabetes or high blood sugar?


1 Yes

2 No

DK/REF


P76 [IF FACILITY = JAIL AND (P71 =1 OR P74 =1)] Since you were admitted to this facility, have you received any medical treatment other than prescription medicine for your diabetes or high blood sugar?


[IF FACILITY = PRISON AND (P71 =1 OR P74 =1)] Since you were admitted to any facility to serve time on your current sentence, have you received any medical treatment other than prescription medicine for your diabetes or high blood sugar?


1 Yes

2 No

DK/REF



P77 [IF FACILITY = JAIL AND P74 = 1 AND P75 = 1], How soon after you were told that you had diabetes or high blood sugar did you start taking prescription medicine at this facility?


[IF FACILITY = PRISON AND P74 = 1 AND P75 = 1] Think about when you were first told that you had diabetes or high blood sugar after you were admitted to any facility to serve time on your current sentence. How soon after you were told did you start taking prescription medicine for your diabetes or high blood sugar?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


P78 [IF FACILITY = JAIL AND P74 = 1 AND P76 =1] How soon after you were told that you had diabetes or high blood sugar did you start receiving any medical treatment other than prescription medicine at this facility?


[IF FACILITY = PRISON AND P74 =1 AND P76 = 1] Think about when you were first told that you had diabetes or high blood sugar after you were admitted to any facility to serve time on your current sentence. How soon after you were told did you start receiving any medical treatment other than prescription medicine for your diabetes or high blood sugar?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


P79 [IF FACILITY = JAIL AND P71 = 1 AND P75 = 1] How soon after you were admitted to this facility did you start taking prescription medicine for your diabetes or high blood sugar?


[IF FACILITY = PRISON AND P71 = 1 AND P75 = 1] How soon after you were admitted to any facility to serve time on your current sentence did you start taking prescription medicine for your diabetes or high blood sugar?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


P80 [IF FACILITY = JAIL AND P71 = 1 AND P76 = 1] How soon after you were admitted to this facility did you start receiving any medical treatment other than prescription medicine for your diabetes or high blood sugar?


[IF FACILITY = PRISON AND P71 = 1 AND P76 = 1] How soon after you were admitted to any facility to serve time on your current sentence did you start receiving any medical treatment other than prescription medicine for your diabetes or high blood sugar?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


P81 [IF P40d = 1] Are you currently taking prescription medicine for your diabetes or high blood sugar?


1 Yes

2 No

DK/REF


P82 [IF P40d = 1] Are you currently receiving any medical treatment other than prescription medicine for your diabetes or high blood sugar?


1 Yes

2 No

DK/REF


P83 [IF P81 = 2] Why aren’t you currently taking prescription medicine for your diabetes or high blood sugar?

Yes

No

P83a. You have not seen a doctor to get the medicine

1

2

P83b. The doctor at the facility doesn’t think you need medicine

1

2

P83c. You don’t like taking the medicine

1

2

P83d. You don’t think you need the medicine

1

2

P83e. The facility is not willing to give the medicine to you

1

2

P83f. You would have to be transferred to a different facility to receive the medicine

1

2

P83g. You don’t currently have diabetes or high blood sugar

1

2

P83h. Some other reason

1

2


P84 [IF FACILITY TYPE = JAIL AND P35e = 1] At the time you were admitted to this facility, did you have a problem with your heart?


[IF FACILITY TYPE = PRISON AND P35e = 1] At the time you were admitted to any facility to serve time on your current sentence, did you have a problem with your heart?


1 Yes

2 No

DK/REF


P85 [IF FACILITY TYPE = JAIL AND P84 = 1] In the 30 days before you were admitted to this facility, were you taking any prescription medicine for your heart problem?


[IF FACILITY TYPE = PRISON AND P84 =1] In the 30 days before you were admitted to any facility to serve time on your current sentence, were you taking any prescription medicine for your heart problem?


1 Yes

2 No

DK/REF


P86 [IF FACILITY TYPE = JAIL AND P84 = 1] In the 30 days before you were admitted to this facility, were you receiving any medical treatment other than prescription medicine for your heart problem?


[IF FACILITY TYPE = PRISON AND P84 =1] In the 30 days before you were admitted to any facility to serve time on your current sentence, were you receiving any medical treatment other than prescription medicine for your heart problem?


1 Yes

2 No

DK/REF


P87 [IF FACILITY = JAIL AND P84 = 2] Since you were admitted to this facility, have you been told by a doctor, nurse, or other health care provider that you had a problem with your heart?


[IF FACILITY = PRISON AND P84 = 2] Since you were admitted to any facility to serve time on your current sentence, have you been told by a doctor, nurse, or other health care provider that you had a problem with your heart?


1 Yes

2 No

DK/REF


P88 [IF FACILITY = JAIL AND (P84 =1 OR P87 =1)] Since you were admitted to this facility, have you taken any prescription medicine for your heart problem?


[IF FACILITY = PRISON AND (P84 =1 OR P87 =1)] Since you were admitted to any facility to serve time on your current sentence, have you taken any prescription medicine for your heart problem?


1 Yes

2 No

DK/REF


P89 [IF FACILITY = JAIL AND (P84 =1 OR P87 =1)] Since you were admitted to this facility, have you received any medical treatment other than prescription medicine for your heart problem?


[IF FACILITY = PRISON AND (P84 =1 OR P87 =1)] Since you were admitted to any facility to serve time on your current sentence, have you received any medical treatment other than prescription medicine for your heart problem?


1 Yes

2 No

DK/REF



P90 [IF FACILITY = JAIL AND P87 = 1 AND P88 = 1], How soon after you were told that you had a problem with your heart did you start taking prescription medicine at this facility?


[IF FACILITY = PRISON AND P87 = 1 AND P88 = 1] Think about when you were first told that you had a problem with your heart after you were admitted to any facility to serve time on your current sentence. How soon after you were told did you start taking prescription medicine for your heart problem?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


P91 [IF FACILITY = JAIL AND P87 = 1 AND P89 =1] How soon after you were told that you had a problem with your heart did you start receiving any medical treatment other than prescription medicine at this facility?


[IF FACILITY = PRISON AND P87 =1 AND P89 = 1] Think about when you were first told that you had a problem with your heart after you were admitted to any facility to serve time on your current sentence. How soon after you were told did you start receiving any medical treatment other than prescription medicine for your heart problem?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


P92 [IF FACILITY = JAIL AND P84 = 1 AND P88 = 1] How soon after you were admitted to this facility did you start taking prescription medicine for your heart problem?


[IF FACILITY = PRISON AND P84 = 1 AND P88 = 1] How soon after you were admitted to any facility to serve time on your current sentence did you start taking prescription medicine for your heart problem?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


P93 [IF FACILITY = JAIL AND P84 = 1 AND P89 = 1] How soon after you were admitted to this facility did you start receiving any medical treatment other than prescription medicine for your heart problem?


[IF FACILITY = PRISON AND P84 = 1 AND P89 = 1] How soon after you were admitted to any facility to serve time on your current sentence did you start receiving any medical treatment other than prescription medicine for your heart problem?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


P94 [IF P40e = 1] Are you currently taking prescription medicine for your heart problem?


1 Yes

2 No

DK/REF


P95 [IF P40e = 1] Are you currently receiving any medical treatment other than prescription medicine for your heart problem?


1 Yes

2 No

DK/REF


P96 [IF P94 = 2] Why aren’t you currently taking prescription medicine for your heart problem?

Yes

No

P96a. You have not seen a doctor to get the medicine

1

2

P96b. The doctor at the facility doesn’t think you need medicine

1

2

P96c. You don’t like taking the medicine

1

2

P96d. You don’t think you need the medicine

1

2

P96e. The facility is not willing to give the medicine to you

1

2

P96f. You would have to be transferred to a different facility to receive the medicine

1

2

P96g. You don’t currently have a heart problem

1

2

P96h. Some other reason

1

2


P97 [IF FACILITY TYPE = JAIL AND P35f = 1] At the time you were admitted to this facility, did you have a problem with your kidneys?


[IF FACILITY TYPE = PRISON AND P35f = 1] At the time you were admitted to any facility to serve time on your current sentence, did you have a problem with your kidneys?


1 Yes

2 No

DK/REF


P98 [IF FACILITY TYPE = JAIL AND P97 = 1] In the 30 days before you were admitted to this facility, were you taking any prescription medicine for your kidney problem?


[IF FACILITY TYPE = PRISON AND P97 =1] In the 30 days before you were admitted to any facility to serve time on your current sentence, were you taking any prescription medicine for your kidney problem?


1 Yes

2 No

DK/REF


P99 [IF FACILITY TYPE = JAIL AND P97 = 1] In the 30 days before you were admitted to this facility, were you receiving any medical treatment other than prescription medicine for your kidney problem?


[IF FACILITY TYPE = PRISON AND P97 =1] In the 30 days before you were admitted to any facility to serve time on your current sentence, were you receiving any medical treatment other than prescription medicine for your kidney problem?


1 Yes

2 No

DK/REF


P100 [IF FACILITY = JAIL AND P97 = 2] Since you were admitted to this facility, have you been told by a doctor, nurse, or other health care provider that you had a problem with your kidneys?


[IF FACILITY = PRISON AND P97 = 2] Since you were admitted to any facility to serve time on your current sentence, have you been told by a doctor, nurse, or other health care provider that you had a problem with your kidneys?


1 Yes

2 No

DK/REF


P101 [IF FACILITY = JAIL AND (P97 =1 OR P100 =1)] Since you were admitted to this facility, have you taken any prescription medicine for your kidney problem?


[IF FACILITY = PRISON AND (P97 =1 OR P100 =1)] Since you were admitted to any facility to serve time on your current sentence, have you taken any prescription medicine for your kidney problem?


1 Yes

2 No

DK/REF


P102 [IF FACILITY = JAIL AND (P97 =1 OR P100 =1)] Since you were admitted to this facility, have you received any medical treatment other than prescription medicine for your kidney problem?


[IF FACILITY = PRISON AND (P97 =1 OR P100 =1)] Since you were admitted to any facility to serve time on your current sentence, have you received any medical treatment other than prescription medicine for your kidney problem?


1 Yes

2 No

DK/REF



P103 [IF FACILITY = JAIL AND P100 = 1 AND P101 = 1], How soon after you were told that you had a problem with your kidneys did you start taking prescription medicine at this facility?


[IF FACILITY = PRISON AND P100 = 1 AND P101 = 1] Think about when you were first told that you had a problem with your kidneys after you were admitted to any facility to serve time on your current sentence. How soon after you were told did you start taking prescription medicine for your kidney problem?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


P104 [IF FACILITY = JAIL AND P100 = 1 AND P102 =1] How soon after you were told that you had a problem with your kidneys did you start receiving any medical treatment other than prescription medicine at this facility?


[IF FACILITY = PRISON AND P100 =1 AND P102 = 1] Think about when you were first told that you had a problem with your kidneys after you were admitted to any facility to serve time on your current sentence. How soon after you were told did you start receiving any medical treatment other than prescription medicine for your kidney problem?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


P105 [IF FACILITY = JAIL AND P97 = 1 AND P101 = 1] How soon after you were admitted to this facility did you start taking prescription medicine for your kidney problem?


[IF FACILITY = PRISON AND P97 = 1 AND P101 = 1] How soon after you were admitted to any facility to serve time on your current sentence did you start taking prescription medicine for your kidney problem?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


P106 [IF FACILITY = JAIL AND P97 = 1 AND P102 = 1] How soon after you were admitted to this facility did you start receiving any medical treatment other than prescription medicine for your kidney problem?


[IF FACILITY = PRISON AND P97 = 1 AND P102 = 1] How soon after you were admitted to any facility to serve time on your current sentence did you start receiving any medical treatment other than prescription medicine for your kidney problem?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


P107 [IF P40f = 1] Are you currently taking prescription medicine for your kidney problem?


1 Yes

2 No

DK/REF


P108 [IF P40f = 1] Are you currently receiving any medical treatment other than prescription medicine for your kidney problem?


1 Yes

2 No

DK/REF


P109 [IF P107 = 2] Why aren’t you currently taking prescription medicine for your kidney problem?

Yes

No

P109a. You have not seen a doctor to get the medicine

1

2

P109b. The doctor at the facility doesn’t think you need medicine

1

2

P109c. You don’t like taking the medicine

1

2

P109d. You don’t think you need the medicine

1

2

P109e. The facility is not willing to give the medicine to you

1

2

P109f. You would have to be transferred to a different facility to receive the medicine

1

2

P109g. You don’t currently have a kidney problem

1

2

P109h. Some other reason

1

2


P110 [IF FACILITY TYPE = JAIL AND P35g = 1] At the time you were admitted to this facility, did you have arthritis or rheumatism?


[IF FACILITY TYPE = PRISON AND P35g = 1] At the time you were admitted to any facility to serve time on your current sentence, did you have arthritis or rheumatism?


1 Yes

2 No

DK/REF


P111 [IF FACILITY TYPE = JAIL AND P110 = 1] In the 30 days before you were admitted to this facility, were you taking any prescription medicine for your arthritis or rheumatism?


[IF FACILITY TYPE = PRISON AND P110 =1] In the 30 days before you were admitted to any facility to serve time on your current sentence, were you taking any prescription medicine for your arthritis or rheumatism?


1 Yes

2 No

DK/REF


P112 [IF FACILITY TYPE = JAIL AND P110 = 1] In the 30 days before you were admitted to this facility, were you receiving any medical treatment other than prescription medicine for your arthritis or rheumatism?


[IF FACILITY TYPE = PRISON AND P110 =1] In the 30 days before you were admitted to any facility to serve time on your current sentence, were you receiving any medical treatment other than prescription medicine for your arthritis or rheumatism?


1 Yes

2 No

DK/REF


P113 [IF FACILITY = JAIL AND P110 = 2] Since you were admitted to this facility, have you been told by a doctor, nurse, or other health care provider that you had arthritis or rheumatism?


[IF FACILITY = PRISON AND P110 = 2] Since you were admitted to any facility to serve time on your current sentence, have you been told by a doctor, nurse, or other health care provider that you had arthritis or rheumatism?


1 Yes

2 No

DK/REF


P114 [IF FACILITY = JAIL AND (P110 =1 OR P113 =1)] Since you were admitted to this facility, have you taken any prescription medicine for your arthritis or rheumatism?


[IF FACILITY = PRISON AND (P110 =1 OR P113 =1)] Since you were admitted to any facility to serve time on your current sentence, have you taken any prescription medicine for your arthritis or rheumatism?


1 Yes

2 No

DK/REF


P115 [IF FACILITY = JAIL AND (P110 =1 OR P113 =1)] Since you were admitted to this facility, have you received any medical treatment other than prescription medicine for your arthritis or rheumatism?


[IF FACILITY = PRISON AND (P110 =1 OR P113 =1)] Since you were admitted to any facility to serve time on your current sentence, have you received any medical treatment other than prescription medicine for your arthritis or rheumatism?


1 Yes

2 No

DK/REF



P116 [IF FACILITY = JAIL AND P113 = 1 AND P114 = 1], How soon after you were told that you had arthritis or rheumatism did you start taking prescription medicine at this facility?


[IF FACILITY = PRISON AND P113 = 1 AND P114 = 1] Think about when you were first told that you had arthritis or rheumatism after you were admitted to any facility to serve time on your current sentence. How soon after you were told did you start taking prescription medicine for your arthritis or rheumatism?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


P117 [IF FACILITY = JAIL AND P113 = 1 AND P115 =1] How soon after you were told that you had arthritis or rheumatism did you start receiving any medical treatment other than prescription medicine at this facility?


[IF FACILITY = PRISON AND P113 =1 AND P115 = 1] Think about when you were first told that you had arthritis or rheumatism after you were admitted to any facility to serve time on your current sentence. How soon after you were told did you start receiving any medical treatment other than prescription medicine for your arthritis or rheumatism?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


P118 [IF FACILITY = JAIL AND P110 = 1 AND P114 = 1] How soon after you were admitted to this facility did you start taking prescription medicine for your arthritis or rheumatism?


[IF FACILITY = PRISON AND P110 = 1 AND P114 = 1] How soon after you were admitted to any facility to serve time on your current sentence did you start taking prescription medicine for your arthritis or rheumatism?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


P119 [IF FACILITY = JAIL AND P110 = 1 AND P115 = 1] How soon after you were admitted to this facility did you start receiving any medical treatment other than prescription medicine for your arthritis or rheumatism?


[IF FACILITY = PRISON AND P110 = 1 AND P115 = 1] How soon after you were admitted to any facility to serve time on your current sentence did you start receiving any medical treatment other than prescription medicine for your arthritis or rheumatism?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


P120 [IF P40g= 1] Are you currently taking prescription medicine for your arthritis or rheumatism?


1 Yes

2 No

DK/REF


P121 [IF P40g = 1] Are you currently receiving any medical treatment other than prescription medicine for your arthritis or rheumatism?


1 Yes

2 No

DK/REF


P122 [IF P120 = 2] Why aren’t you currently taking prescription medicine for your arthritis or rheumatism?

Yes

No

P122a. You have not seen a doctor to get the medicine

1

2

P122b. The doctor at the facility doesn’t think you need medicine

1

2

P122c. You don’t like taking the medicine

1

2

P122d. You don’t think you need the medicine

1

2

P122e. The facility is not willing to give the medicine to you

1

2

P122f. You would have to be transferred to a different facility to receive the medicine

1

2

P122g. You don’t currently have arthritis or rheaumatism

1

2

P122h. Some other reason

1

2


P123 [IF FACILITY TYPE = JAIL AND P35h = 1] At the time you were admitted to this facility, did you have asthma?


[IF FACILITY TYPE = PRISON AND P35h = 1] At the time you were admitted to any facility to serve time on your current sentence, did you have asthma?


1 Yes

2 No

DK/REF


P124 [IF FACILITY TYPE = JAIL AND P123 = 1] In the 30 days before you were admitted to this facility, were you taking any prescription medicine for your asthma?


[IF FACILITY TYPE = PRISON AND P123 =1] In the 30 days before you were admitted to any facility to serve time on your current sentence, were you taking any prescription medicine for your asthma?


1 Yes

2 No

DK/REF


P125 [IF FACILITY TYPE = JAIL AND P123 = 1] In the 30 days before you were admitted to this facility, were you receiving any medical treatment other than prescription medicine for your asthma?


[IF FACILITY TYPE = PRISON AND P123 =1] In the 30 days before you were admitted to any facility to serve time on your current sentence, were you receiving any medical treatment other than prescription medicine for your asthma?


1 Yes

2 No

DK/REF


P126 [IF FACILITY = JAIL AND P123 = 2] Since you were admitted to this facility, have you been told by a doctor, nurse, or other health care provider that you had asthma?


[IF FACILITY = PRISON AND P123 = 2] Since you were admitted to any facility to serve time on your current sentence, have you been told by a doctor, nurse, or other health care provider that you had asthma?


1 Yes

2 No

DK/REF


P127 [IF FACILITY = JAIL AND (P123 =1 OR P126 =1)] Since you were admitted to this facility, have you taken any prescription medicine for your asthma?


[IF FACILITY = PRISON AND (P123 =1 OR P126 =1)] Since you were admitted to any facility to serve time on your current sentence, have you taken any prescription medicine for your asthma?


1 Yes

2 No

DK/REF


P128 [IF FACILITY = JAIL AND (P123 =1 OR P126 =1)] Since you were admitted to this facility, have you received any medical treatment other than prescription medicine for your asthma?


[IF FACILITY = PRISON AND (P123 =1 OR P126 =1)] Since you were admitted to any facility to serve time on your current sentence, have you received any medical treatment other than prescription medicine for your asthma?


1 Yes

2 No

DK/REF



P129 [IF FACILITY = JAIL AND P126 = 1 AND P127 = 1], How soon after you were told that you had asthma did you start taking prescription medicine at this facility?


[IF FACILITY = PRISON AND P126 = 1 AND P127 = 1] Think about when you were first told that you had asthma after you were admitted to any facility to serve time on your current sentence. How soon after you were told did you start taking prescription medicine for your asthma?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


P130 [IF FACILITY = JAIL AND P126 = 1 AND P128 =1] How soon after you were told that you had asthma did you start receiving any medical treatment other than prescription medicine at this facility?


[IF FACILITY = PRISON AND P126 =1 AND P128 = 1] Think about when you were first told that you had asthma after you were admitted to any facility to serve time on your current sentence. How soon after you were told did you start receiving any medical treatment other than prescription medicine for your asthma?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


P131 [IF FACILITY = JAIL AND P123 = 1 AND P127 = 1] How soon after you were admitted to this facility did you start taking prescription medicine for your asthma?


[IF FACILITY = PRISON AND P123 = 1 AND P127 = 1] How soon after you were admitted to any facility to serve time on your current sentence did you start taking prescription medicine for your asthma?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


P132 [IF FACILITY = JAIL AND P123 = 1 AND P128 = 1] How soon after you were admitted to this facility did you start receiving any medical treatment other than prescription medicine for your asthma?


[IF FACILITY = PRISON AND P123 = 1 AND P128 = 1] How soon after you were admitted to any facility to serve time on your current sentence did you start receiving any medical treatment other than prescription medicine for your asthma?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


P133 [IF P40h= 1] Are you currently taking prescription medicine for your asthma?


1 Yes

2 No

DK/REF


P134 [IF P40h = 1] Are you currently receiving any medical treatment other than prescription medicine for your asthma?


1 Yes

2 No

DK/REF


P135 [IF P133 = 2] Why aren’t you currently taking prescription medicine for your asthma?

Yes

No

P135a. You have not seen a doctor to get the medicine

1

2

P135b. The doctor at the facility doesn’t think you need medicine

1

2

P135c. You don’t like taking the medicine

1

2

P135d. You don’t think you need the medicine

1

2

P135e. The facility is not willing to give the medicine to you

1

2

P135f. You would have to be transferred to a different facility to receive the medicine

1

2

P135g. You don’t currently have asthma

1

2

P135h. Some other reason

1

2


P136 [IF FACILITY TYPE = JAIL AND P35i = 1] At the time you were admitted to this facility, did you have cirrhosis of the liver?


[IF FACILITY TYPE = PRISON AND P35i = 1] At the time you were admitted to any facility to serve time on your current sentence, did you have cirrhosis of the liver?


1 Yes

2 No

DK/REF


P137 [IF FACILITY TYPE = JAIL AND P136 = 1] In the 30 days before you were admitted to this facility, were you taking any prescription medicine for your cirrhosis of the liver?


[IF FACILITY TYPE = PRISON AND P136 =1] In the 30 days before you were admitted to any facility to serve time on your current sentence, were you taking any prescription medicine for your cirrhosis of the liver?


1 Yes

2 No

DK/REF


P138 [IF FACILITY TYPE = JAIL AND P136 = 1] In the 30 days before you were admitted to this facility, were you receiving any medical treatment other than prescription medicine for your cirrhosis of the liver?


[IF FACILITY TYPE = PRISON AND P136 =1] In the 30 days before you were admitted to any facility to serve time on your current sentence, were you receiving any medical treatment other than prescription medicine for your cirrhosis of the liver?


1 Yes

2 No

DK/REF


P139 [IF FACILITY = JAIL AND P136 = 2] Since you were admitted to this facility, have you been told by a doctor, nurse, or other health care provider that you had cirrhosis of the liver?


[IF FACILITY = PRISON AND P136 = 2] Since you were admitted to any facility to serve time on your current sentence, have you been told by a doctor, nurse, or other health care provider that you had cirrhosis of the liver?


1 Yes

2 No

DK/REF


P140 [IF FACILITY = JAIL AND (P136 =1 OR P139 =1)] Since you were admitted to this facility, have you taken any prescription medicine for your cirrhosis of the liver?


[IF FACILITY = PRISON AND (P136 =1 OR P139 =1)] Since you were admitted to any facility to serve time on your current sentence, have you taken any prescription medicine for your cirrhosis of the liver?


1 Yes

2 No

DK/REF


P141 [IF FACILITY = JAIL AND (P136 =1 OR P139 =1)] Since you were admitted to this facility, have you received any medical treatment other than prescription medicine for your cirrhosis of the liver?


[IF FACILITY = PRISON AND (P136 =1 OR P139 =1)] Since you were admitted to any facility to serve time on your current sentence, have you received any medical treatment other than prescription medicine for your cirrhosis of the liver?


1 Yes

2 No

DK/REF



P142 [IF FACILITY = JAIL AND P139 = 1 AND P140 = 1], How soon after you were told that you had cirrhosis of the liver did you start taking prescription medicine at this facility?


[IF FACILITY = PRISON AND P139 = 1 AND P140 = 1] Think about when you were first told that you had cirrhosis of the liver after you were admitted to any facility to serve time on your current sentence. How soon after you were told did you start taking prescription medicine for your cirrhosis of the liver?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


P143 [IF FACILITY = JAIL AND P139 = 1 AND P141 =1] How soon after you were told that you had cirrhosis of the liver did you start receiving any medical treatment other than prescription medicine at this facility?


[IF FACILITY = PRISON AND P139 =1 AND P141 = 1] Think about when you were first told that you had cirrhosis of the liver after you were admitted to any facility to serve time on your current sentence. How soon after you were told did you start receiving any medical treatment other than prescription medicine for your cirrhosis of the liver?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


P144 [IF FACILITY = JAIL AND P136 = 1 AND P140 = 1] How soon after you were admitted to this facility did you start taking prescription medicine for your cirrhosis of the liver?


[IF FACILITY = PRISON AND P136 = 1 AND P140 = 1] How soon after you were admitted to any facility to serve time on your current sentence did you start taking prescription medicine for your cirrhosis of the liver?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


P145 [IF FACILITY = JAIL AND P136 = 1 AND P141 = 1] How soon after you were admitted to this facility did you start receiving any medical treatment other than prescription medicine for your cirrhosis of the liver?


[IF FACILITY = PRISON AND P136 = 1 AND P141 = 1] How soon after you were admitted to any facility to serve time on your current sentence did you start receiving any medical treatment other than prescription medicine for your cirrhosis of the liver?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


P146 [IF P40i= 1] Are you currently taking prescription medicine for your cirrhosis of the liver?


1 Yes

2 No

DK/REF


P147 [IF P40i = 1] Are you currently receiving any medical treatment other than prescription medicine for your cirrhosis of the liver?


1 Yes

2 No

DK/REF


P148 [IF P146 = 2] Why aren’t you currently taking prescription medicine for your cirrhosis of the liver?

Yes

No

P148a. You have not seen a doctor to get the medicine

1

2

P148b. The doctor at the facility doesn’t think you need medicine

1

2

P148c. You don’t like taking the medicine

1

2

P148d. You don’t think you need the medicine

1

2

P148e. The facility is not willing to give the medicine to you

1

2

P148f. You would have to be transferred to a different facility to receive the medicine

1

2

P148g. You don’t currently have cirrhosis of the liver

1

2

P148h. Some other reason

1

2



P149 [IF FACILITY TYPE = JAIL AND P36 = 1] At the time you were admitted to this facility, were you experiencing any type of paralysis or were you unable to move some part of your body?


[IF FACILITY TYPE = PRISON AND P36 = 1] At the time you were admitted to any facility to serve time on your current sentence, were you experiencing any type of paralysis or were you unable to move some part of your body?


1 Yes

2 No

DK/REF


P150 [IF FACILITY TYPE = JAIL AND P149 = 1] In the 30 days before you were admitted to this facility, were you taking any prescription medicine for your paralysis?


[IF FACILITY TYPE = PRISON AND P149 =1] In the 30 days before you were admitted to any facility to serve time on your current sentence, were you taking any prescription medicine for your paralysis?


1 Yes

2 No

DK/REF


P151 [IF FACILITY TYPE = JAIL AND P149 = 1] In the 30 days before you were admitted to this facility, were you receiving any medical treatment other than prescription medicine for your paralysis?


[IF FACILITY TYPE = PRISON AND P149 =1] In the 30 days before you were admitted to any facility to serve time on your current sentence, were you receiving any medical treatment other than prescription medicine for your paralysis?


1 Yes

2 No

DK/REF


P152 [IF FACILITY = JAIL AND P149 = 2] Since you were admitted to this facility, have you experienced any type of paralysis or been unable to move some part of your body?


[IF FACILITY = PRISON AND P149 = 2] Since you were admitted to any facility to serve time on your current sentence, have you experienced any type of paralysis or been unable to move some part of your body?


1 Yes

2 No

DK/REF


P153 [IF FACILITY = JAIL AND (P149 =1 OR P152 =1)] Since you were admitted to this facility, have you taken any prescription medicine for your paralysis?


[IF FACILITY = PRISON AND (P149 =1 OR P152 =1)] Since you were admitted to any facility to serve time on your current sentence, have you taken any prescription medicine for your paralysis?


1 Yes

2 No

DK/REF


P154 [IF FACILITY = JAIL AND (P149 =1 OR P152 =1)] Since you were admitted to this facility, have you received any medical treatment other than prescription medicine for your paralysis?


[IF FACILITY = PRISON AND (P149 =1 OR P152 =1)] Since you were admitted to any facility to serve time on your current sentence, have you received any medical treatment other than prescription medicine for your paralysis?


1 Yes

2 No

DK/REF



P155 [IF FACILITY = JAIL AND P152 = 1 AND P153 = 1], How soon after you began experiencing any type of paralysis did you start taking prescription medicine at this facility?


[IF FACILITY = PRISON AND P152 = 1 AND P153 = 1] Think about when you first experienced any type of paralysis after you were admitted to any facility to serve time on your current sentence. How soon after you were told did you start taking prescription medicine for your paralysis?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


P156 [IF FACILITY = JAIL AND P152 = 1 AND P154 =1] How soon after you began experiencing any type of paralysis did you start receiving any medical treatment other than prescription medicine at this facility?


[IF FACILITY = PRISON AND P152 =1 AND P154 = 1] Think about when you first experienced any type of paralysis after you were admitted to any facility to serve time on your current sentence. How soon after you were told did you start receiving any medical treatment other than prescription medicine for your paralysis?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


P157 [IF FACILITY = JAIL AND P149 = 1 AND P153 = 1] How soon after you were admitted to this facility did you start taking prescription medicine for your paralysis?


[IF FACILITY = PRISON AND P149 = 1 AND P153 = 1] How soon after you were admitted to any facility to serve time on your current sentence did you start taking prescription medicine for your paralysis?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


P158 [IF FACILITY = JAIL AND P149 = 1 AND P154 = 1] How soon after you were admitted to this facility did you start receiving any medical treatment other than prescription medicine for your paralysis?


[IF FACILITY = PRISON AND P149 = 1 AND P154 = 1] How soon after you were admitted to any facility to serve time on your current sentence did you start receiving any medical treatment other than prescription medicine for your paralysis?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


P159 [IF P41= 1] Are you currently taking prescription medicine for your paralysis?


1 Yes

2 No

DK/REF


P160 [IF P41 = 1] Are you currently receiving any medical treatment other than prescription medicine for your paralysis?


1 Yes

2 No

DK/REF


P161 [IF P159 = 2] Why aren’t you currently taking prescription medicine for your paralysis?

Yes

No

P161a. You have not seen a doctor to get the medicine

1

2

P161b. The doctor at the facility doesn’t think you need medicine

1

2

P161c. You don’t like taking the medicine

1

2

P161d. You don’t think you need the medicine

1

2

P161e. The facility is not willing to give the medicine to you

1

2

P161f. You would have to be transferred to a different facility to receive the medicine

1

2

P161g. You don’t currently have paralysis

1

2

P161h. Some other reason

1

2


P162 [IF FACILITY TYPE = JAIL AND P37 = 1] At the time you were admitted to this facility, were you experiencing any problems because you were knocked unconscious at some time in the past?


[IF FACILITY TYPE = PRISON AND P37 = 1] At the time you were admitted to any facility to serve time on your current sentence, were you experiencing any problems because you were knocked unconscious at some time in the past?


1 Yes

2 No

DK/REF


P163 [IF FACILITY TYPE = JAIL AND P162 = 1] In the 30 days before you were admitted to this facility, were you taking any prescription medicine for problems you were experiencing because you were knocked unconscious at some time in the past?


[IF FACILITY TYPE = PRISON AND P162 =1] In the 30 days before you were admitted to any facility to serve time on your current sentence, were you taking any prescription medicine for problems you were experiencing because you were knocked unconscious at some time in the past?


1 Yes

2 No

DK/REF


P164 [IF FACILITY TYPE = JAIL AND P162 = 1] In the 30 days before you were admitted to this facility, were you receiving any medical treatment other than prescription medicine for problems you were experiencing because you were knocked unconscious at some time in the past?


[IF FACILITY TYPE = PRISON AND P162 =1] In the 30 days before you were admitted to any facility to serve time on your current sentence, were you receiving any medical treatment other than prescription medicine for problems you were experiencing because you were knocked unconscious at some time in the past?


1 Yes

2 No

DK/REF


P165 [IF FACILITY = JAIL AND P162 = 2] Since you were admitted to this facility, have you experienced any problems because you were knocked unconscious at some time in the past?


[IF FACILITY = PRISON AND P162 = 2] Since you were admitted to any facility to serve time on your current sentence, have you experienced problems because you were knocked unconscious at some time in the past?


1 Yes

2 No

DK/REF


P166 [IF FACILITY = JAIL AND (P162 =1 OR P165 =1)] Since you were admitted to this facility, have you taken any prescription medicine for problems you were experiencing because you were knocked unconscious at some time in the past?


[IF FACILITY = PRISON AND (P162 =1 OR P165 =1)] Since you were admitted to any facility to serve time on your current sentence, have you taken any prescription medicine for problems you were experiencing because you were knocked unconscious at some time in the past?


1 Yes

2 No

DK/REF


P167 [IF FACILITY = JAIL AND (P162 =1 OR P165 =1)] Since you were admitted to this facility, have you received any medical treatment other than prescription medicine for problems you were experiencing because you were knocked unconscious at some time in the past?


[IF FACILITY = PRISON AND (P162 =1 OR P165 =1)] Since you were admitted to any facility to serve time on your current sentence, have you received any medical treatment other than prescription medicine for problems you were experiencing because you were knocked unconscious at some time in the past?


1 Yes

2 No

DK/REF



P168 [IF FACILITY = JAIL AND P165 = 1 AND P166 = 1], How soon after you began experiencing problems because you were knocked unconscious at some time in the past did you start taking prescription medicine at this facility?


[IF FACILITY = PRISON AND P165 = 1 AND P166 = 1] Think about when you first experienced any problems because you were knocked unconscious at some time in the past after you were admitted to any facility to serve time on your current sentence. How soon after you were told did you start taking prescription medicine for problems you were experiencing because you were knocked unconscious at some time in the past?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


P169 [IF FACILITY = JAIL AND P165 = 1 AND P167 =1] How soon after you began experiencing problems because you were knocked unconscious at some time in the past did you start receiving any medical treatment other than prescription medicine at this facility?


[IF FACILITY = PRISON AND P165 =1 AND P167 = 1] Think about when you first experienced problems because you were knocked unconscious at some time in the past after you were admitted to any facility to serve time on your current sentence. How soon after you were told did you start receiving any medical treatment other than prescription medicine for problems you were experiencing because you were knocked unconscious at some time in the past?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


P170 [IF FACILITY = JAIL AND P162 = 1 AND P166 = 1] How soon after you were admitted to this facility did you start taking prescription medicine for problems you were experiencing because you were knocked unconscious at some time in the past?


[IF FACILITY = PRISON AND P162 = 1 AND P166 = 1] How soon after you were admitted to any facility to serve time on your current sentence did you start taking prescription medicine for problems you were experiencing because you were knocked unconscious at some time in the past?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


P171 [IF FACILITY = JAIL AND P162 = 1 AND P167 = 1] How soon after you were admitted to this facility did you start receiving any medical treatment other than prescription medicine for problems you were experiencing because you were knocked unconscious at some time in the past?


[IF FACILITY = PRISON AND P162 = 1 AND P167 = 1] How soon after you were admitted to any facility to serve time on your current sentence did you start receiving any medical treatment other than prescription medicine for problems you were experiencing because you were knocked unconscious at some time in the past?


1 Within 2 days

2 More than 2 days but within 7 days

3 More than 7 days but within 14 days

4 More than 14 days but with 30 days

5 More than 30 days

DK/REF


P172 [IF P42= 1] Are you currently taking prescription medicine for problems you were experiencing because you were knocked unconscious at some time in the past?


1 Yes

2 No

DK/REF


P173 [IF P42 = 1] Are you currently receiving any medical treatment other than prescription medicine for problems you were experiencing because you were knocked unconscious at some time in the past?


1 Yes

2 No

DK/REF


P174 [IF P172 = 2] Why aren’t you currently taking prescription medicine for problems you were experiencing because you were knocked unconscious at some time in the past?

Yes

No

P174a. You have not seen a doctor to get the medicine

1

2

P174b. The doctor at the facility doesn’t think you need medicine

1

2

P174c. You don’t like taking the medicine

1

2

P174d. You don’t think you need the medicine

1

2

P174e. The facility is not willing to give the medicine to you

1

2

P174f. You would have to be transferred to a different facility to receive the medicine

1

2

P174g. You don’t currently experience problems because you were knocked unconscious at some time in the past

1

2

P174h. Some other reason

1

2

Section J – Drug Use


TIME STAMP HERE


J1. These next questions are about using drugs other than alcohol.


Have you ever used...

YES

NO

J1a. Heroin?

1

2

J1b. Other opiates, for example, darvon, percocet, or oxycontin without a doctor’s prescription or methadone outside a treatment program?

1

2

J1c. Methamphetamine such as ice or crank?

1

2

J1d. Other amphetamines such as speed without a doctor’s prescription?

1

2

J1e. Methaqualone such as quaaludes without a doctor’s prescription?

1

2

J1f. Barbiturates such as downers without a doctor’s prescription?

1

2

J1g. Tranquilizers such as valium without a doctor’s prescription?

1

2

J1h Crack?

1

2

J1i. Cocaine other than crack?

1

2

J1j. PCP?

1

2

J1k. Ecstasy?

1

2

J1l. LSD or other hallucinogens?

1

2

J1m. Marijuana or hashish?

1

2

J1n. Any other drugs that we didn’t mention?

1

2

J1o. Inhalants or sniffed substances to get high, for example nitrous oxide, aerosols, paint thinner, glue, lighter fluid, spray paint, or gasoline?

1

2


J1a1 [IF J1a = 1] How old were you the first time you used heroin?


AGE: ____________ [RANGE: 1 – 99]

DK/REF


J1b1 [IF J1b = 1] How old were you the first time you used other opiates such as darvon, percocet, or oxycontin without a doctor’s prescription or methadone outside a treatment program?


AGE: ____________ [RANGE: 1 – 99]

DK/REF


J1c1 [IF J1c = 1] How old were you the first time you used methamphetamine such as ice or crank?


AGE: ____________ [RANGE: 1 – 99]

DK/REF


J1d1 [IF J1d = 1] How old were you the first time you used some other amphetamine such as speed without a doctor’s prescription?


AGE: ____________ [RANGE: 1 – 99]

DK/REF


J1e1 [IF J1e = 1] How old were you the first time you used methaqualone such as quaaludes without a doctor’s prescription?


AGE: ____________ [RANGE: 1 – 99]

DK/REF


J1f1 [IF J1f = 1] How old were you the first time you used barbiturates such as downers without a doctor’s prescription?


AGE: ____________ [RANGE: 1 – 99]

DK/REF


J1g1 [IF J1g = 1] How old were you the first time you used tranquilizers such as valium without a doctor’s prescription?


AGE: ____________ [RANGE: 1 – 99]

DK/REF


J1h1 [IF J1h = 1] How old were you the first time you used crack?


AGE: ____________ [RANGE: 1 – 99]

DK/REF


J1i1 [IF J1i = 1] How old were you the first time you used cocaine other than crack?


AGE: ____________ [RANGE: 1 – 99]

DK/REF


J1j1 [IF J1j = 1] How old were you the first time you used PCP?


AGE: ____________ [RANGE: 1 – 99]

DK/REF


J1k1 [IF J1k = 1] How old were you the first time you used ecstasy?


AGE: ____________ [RANGE: 1 – 99]

DK/REF


J1l1 [IF J1l = 1] How old were you the first time you used LSD or other hallucinogens?


AGE: ____________ [RANGE: 1 – 99]

DK/REF


J1m1 [IF J1m = 1] How old were you the first time you used marijuana or hashish?


AGE: ____________ [RANGE: 1 – 99]

DK/REF


J1n1 [IF J1n = 1] How old were you the first time you used any other drugs?


AGE: ____________ [RANGE: 1 – 99]

DK/REF


J1o1 [IF J1o = 1] How old were you the first time you used any inhalant to get high?


AGE: ____________ [RANGE: 1 – 99]

DK/REF


DO FOR x = a to o

J2x. [IF J1x = 1] Have you ever used [FILL FROM J1x] once a week or more for at least a month?


1 Yes

2 No

DK/REF


J3x. [IF J1x = 1] During the month before you were admitted to this facility, were you using [FILL FROM J1x]?


1 Yes

2 No

DK/REF


J4x. [IF J3x = 1] How often did you use [FILL FROM J1x] during the month before you were admitted to this facility?


1 Less than once a week

2 At least once a week

3 Almost daily

4 Daily

DK/REF


J5. [IF ANY J1x = 1] When you committed the offense for which you are now incarcerated, were you trying to get money to buy drugs or obtain drugs for your use?


1 Yes

2 No

DK/REF


J6. [IF ANY J1x = 1] Were you under the influence of drugs at the time of the offense for which you are now incarcerated?


1 Yes

2 No

DK/REF


J7. [IF J6 = 1] What drugs were you under the influence of at the time of the offense for which you are now incarcerated?



YES

NO

J7a. [IF J1a=1]Heroin?

1

2

J7b. [IF J1b=1]Other opiates, for example, darvon percocet, or oxycontin without a doctor’s prescription or methadone outside a treatment program?

1

2

J7c. [IF J1c=1]Methamphetamine such as ice or crank?

1

2

J7d. [IF J1d=1]Other amphetamines such as speed without a doctor’s prescription?

1

2

J7e. [IF J1e=1]Methaqualone such as quaaludes without a doctor’s prescription?

1

2

J7f. [IF J1f=1]Barbiturates such as downers without a doctor’s prescription?

1

2

J7g. [IF J1g=1]Tranquilizers such as valium without a doctor’s prescription?

1

2

J7h [IF J1h=1]Crack?

1

2

J7i. [IF J1i=1]Cocaine other than crack?

1

2

J7j. [IF J1j=1]PCP?

1

2

J7k. [IF J1k=1]Ecstasy?

1

2

J7l. [IF J1l=1]LSD or other hallucinogens?

1

2

J7m. [IF J1m=1]Marijuana or hashish?

1

2

J7n. [IF J1n=1]Any other drugs that we didn’t mention?

1

2

J7o. [IF J1o=1]Inhalants or sniffed substances to get high, for example nitrous oxide, aerosols, paint thinner, glue, lighter fluid, or gasoline?

1

2


J8. [IF ANY J3x = 1] In the month prior to being admitted to this facility, how did you get the drugs you were using?

YES

NO

J8a. Bought them from a stranger?

1

2

J8b. Bought them from a dealer you know?

1

2

J8c. Bought them from a friend?

1

2

J8d. Stole them?

1

2

J8e. Given to you by friends or acquaintances?

1

2

J8f. Used a fake or forged prescription?

1

2

J8g. Traded sex for the drugs?

1

2

J8h Got the drugs some other way?

1

2


J9. [IF MORE THAN 1 “YES” IN J8] What was the main way you got the drugs you were using in the month prior to being admitted to this facility?


[IF J8a=1]1 Bought them from a stranger

[IF J8b=1]2 Bought them from a dealer you know

[IF J8c=1]3 Bought them from a friend

[IF J8d=1]4 Stole them

[IF J8e=1]5 Given to you by friends or acquaintances

[IF J8f=1]6 Used a fake or forged prescription

[IF J8g=1]7 Traded sex for the drugs

[IF J8h=1]8 Got the drugs some other way

DK/REF


J10. [IF ANY J1x = 1] Have you ever used a needle to get any drug injected under your skin, into a muscle or into a vein for non-medical reasons?


1 Yes

2 No

DK/REF


J11. [IF J10 = 1 AND (J1a = 1 OR J1b = 1 OR J1c = 1 OR J1i = 1 OR J1n = 1)] What kinds of drugs have you ever used with a needle?



YES

NO

J11a. [IF J1a=1]Heroin?

1

2

J11b. [IF J1b=1]Other opiates, for example, darvon, percocet, or oxycontin without a doctor’s prescription or methadone outside a treatment program?

1

2

J11c. [IF J1c=1]Methamphetamine such as ice or crank?

1

2

J11i. [IF J1i=1]Cocaine other than crack?

1

2

J11n. [IF J1n=1] Some other drug?

1

2


J12. [IF J10 = 1] Have you ever used a needle that you knew or suspected had been used by someone else for injecting drugs or shared a needle that you had used with someone else?


1 Yes

2 No

DK/REF


J13. [IF ANY J1x = 1] These next questions are about experiences many people have in connection with their use of drugs.


In your entire life, have you ever driven a car, motorcycle, truck, boat, or any other motor vehicle while under the influence of a drug?


1 Yes

2 No

DK/REF

J14. [IF J13 = 1] In your entire life, have you ever had an accident while driving a motor vehicle while under the influence of a drug?


1 Yes

2 No

DK/REF

J15. [IF ANY J1x = 1] During the year before you were admitted to this facility…

YES

NO

J15a. Did you get into situations while using drugs or just after using drugs that increased your chances of getting hurt – like driving a car or other vehicle, swimming, using machinery or walking in a dangerous area or around heavy traffic?

1

2

J15b. Did you have arguments with your spouse, boyfriend or girlfriend, family, or friends while under the influence of a drug?

1

2

J15c. Did you lose a job because of your drug use?

1

2

J15d. Did you have job or school trouble because of your drug use like missing too much work, not doing your work well, being demoted at work, or dropping out of school?

1

2

J15e. Did you get arrested or held at a police station because of your drug use?

1

2

J15f. Did you get into a physical fight while under the influence of a drug?

1

2



J16. [IF ANY J1x = 1] During the year before you were admitted to this facility...




YES

NO

J16a. Did you often use a drug in larger amounts or for longer periods than you meant to?

1

2

J16b. Did you more than once want to cut down on your drug use or try to cut down on your drug use but found you couldn’t do it?

1

2

J16c. Did you spend a lot of time getting drugs, using them or getting over the bad after-effects?

1

2

J16d. Did using drugs or being sick from using drugs keep you from doing work, going to school, or caring for children?



J16e. Did you give up activities that you were interested in or that were important to you in favor of using drugs like – work, school, hobbies, or associating with family and friends?

1

2

J16f. Did you continue to use drugs even though it was causing emotional or psychological problems?

1

2





J17. [IF ANY J1x = 1] During the year before you were admitted to this facility...



YES

NO

J17a. Did you continue to use drugs even though it was causing problems with family, friends, or work?

1

2

J17b. Did you continue to use drugs even though it was causing physical health or medical problems?

1

2

J17c. Did your usual amount of drugs have less effect on you than it once did or did you have to use more to get the effect you wanted?

1

2

J17d. Did you experience some of the bad after-effects of using drugs after cutting down or stopping your drug use – like shaking, feeling nervous or anxious, sick to your stomach, restless, sweating, or having trouble sleeping or fits or seizures, or see, feel, or hear things that weren’t really there?

1

2

J17e. Did you ever keep using drugs to get over any of the bad after-effects of a drug or to keep from having bad after-effects?

1

2



J18. When you were arrested and booked the last time, were you tested for drugs?


1 Yes

2 No

DK/REF


J19. [IF J18=1] What was the result of the drug test you took when you were arrested and book the last time?


1 Positive for drug use

2 Negative

3 Neither, inconclusive

DK/REF


J20. Have you been tested for drugs since your admission to this facility?


1 Yes

2 No

DK/REF


J21. [IF J20=1] Have you been told the results of any of the drug tests you have taken since you were admitted to this facility?


1 Yes

2 No

DK/REF


J22. [IF J21=1]Were any of the drug tests you have taken since you were admitted to this facility positive?

1 Yes

2 No

DK/REF


Section H – Alcohol Use

TIME STAMP HERE

NOTE TO PROGRAMMERS: If respondent’s time in interview is equal to or less than 32minutes continue with H1. Otherwise skip to M0.


H1 The next questions are about drinking alcohol.


In your entire life, have you had at least 12 drinks of any kind of alcohol, not counting small tastes or sips?

1 YES

2 NO

DK/REF


H2 [IF H1=1] About how old were you when you first started drinking alcohol, other than small tastes or sips?

AGE: _____________________ [RANGE: 1 – 99]

DK/REF


H3 [IF H1=1] Have you ever drunk alcoholic beverages, more than once a week for more than a month?


1 YES

2 NO

DK/REF


H4 [IF H1=1] During the year before you were admitted to this facility, did you drink any alcohol?


1 YES

2 NO

DK/REF


H5 [IF H4=1] During that year how often did you usually drink alcohol?


1 Daily or almost daily

2 At least once a week

3 Less than once a week

4 About once a month

5 Less than once a month

DK/REF


H6 [IF H1=1] Had you been drinking any alcohol at the time of the offense you are now incarcerated for?


1 YES

2 NO

DK/REF


H7 [IF H6=1] About how many hours had you been drinking?


Hours: _________ [RANGE: 1 – 999]

DK/REF


DEFINE HOURSFILL

IF H7 = 1 HOURSFILL = hour

IF H7 > 1 OR H7 = DK OR H7 = REF, HOURSFILL = hours


H8 [IF H6=1] In the [HOURSFILL] before you were admitted to this facility, did you drink any –

YES

NO

H8a. Beer?

1

2

H8b. Wine, wine coolers, champagne, or sparkling wine?

1

2

H8c. Liquor, including mixed drinks and liqueurs?

1

2


H9 [IF H3=1 OR (H5=1 OR 2)] Here are some experiences many people have in connection with their drinking. In your entire life,

YES

NO

H9a. Have you ever felt you should cut down on your drinking?

1

2

H9b. Have people ever annoyed you by criticizing your drinking?

1

2

H9c. Have you ever felt bad or guilty about your drinking?

1

2

H9d. Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover?

1

2



H10. [IF H1=1] In your entire life, have you ever driven a car, motorcycle, truck, boat, or any other vehicle after having too much to drink?


1 Yes

2 No

DK/REF


H11. [IF H10=1] In your entire life, have you ever had an accident after you were drinking?


1 Yes

2 No

DK/REF


H12. [IF H1 = 1] In your entire life, have you ever had as much as a fifth of liquor in one day – that would be about 20 drinks, or 3 bottles of wine, or as much as 3 six-packs of beer in one day?


1 Yes

2 No

DK/REF

H13 [IF H4=1] During the year before your admission to this facility,



YES

NO

H13a. Did you get into situations while drinking or after drinking that increased your chances of getting hurt – like driving a car or other vehicle, swimming, using machinery or walking in a dangerous area or around heavy traffic?

1

2

H13b. Did you have arguments with your spouse, boyfriend or girlfriend, family, or friends while drinking or right after drinking?

1

2

H13c. Did you lose a job because of your drinking?

1

2

H13d. Did you have job or school trouble because of your drinking-like missing too much work, not doing your work well, being demoted at work, or dropping out of school?

1

2

H13e. Did you get arrested or held at a police station because of your drinking?

1

2

H13f. Did you get into a physical fight while drinking or right after drinking?

1

2


H14 [IF H4=1] During the year before your admission to this facility,

YES

NO

H14a Did you often drink more or for longer periods of time than you meant to?

1

2

H14b. Did you more than once want to cut down on your drinking or try to cut down on your drinking but found you couldn’t do it?

1

2

H14c. Did you spend a lot of time drinking or getting over the bad after-effects of drinking?

1

2

H14d. Did your drinking or being sick from drinking keep you from doing work, going to school or caring for children?

1

2

H14e. Did you give up activities that you were interested in or were important to you in favor of drinking – like work, school, hobbies, or associating with family and friends?

1

2

H14f. Did you continue to drink even though it was causing emotional or psychological problems?

1

2



H15 [IF H4=1] During the year before your admission to this facility,

YES

NO

H15a. Did you continue to drink even though it was causing problems with family, friends, or work?

1

2

H15b. Did you continue to drink even though it was causing physical health or medical problems?

1

2

H15c. Did your usual number of drinks have less effect on you than it once did or did you have to drink more to get the effect you wanted?

1

2

H15d. Did you find that you experienced some of the bad after-effects of drinking after cutting down on your drinking or stop drinking – shaking, feeling nervous or anxious, sick to your stomach, restless, sweating, or having trouble sleeping or fits or seizures, or see, feel or hear things that weren’t really there?

1

2

H15e. Did you often take a drink or use any other drug to get over any of the bad after-effects of drinking or to keep from having them?

1

2


Section K – Treatment

TIME STAMP HERE

NOTE TO PROGRAMMERS: If respondent’s time in interview is equal to or less than 32 mintues continue with K1. Otherwise skip to M0.


K1. [IF J1a = 1 OR J1b = 1 OR J1c = 1 OR J1d = 1 OR J1e = 1 OR J1f = 1 OR J1g = 1 OR J1h = 1 OR J1i = 1 OR J1j = 1 OR J1k = 1 OR J1l = 1 OR J1m = 1 OR J1n = 1 OR J1o = 1 OR H1 = 1] These next questions are about alcohol and drug treatment programs you may have attended.


Have you ever attended any kind of alcohol or drug treatment program?


1 Yes

2 No

DK/REF


K2. [IF K1 = 1] What types of alcohol or drug treatment programs have you ever attended?



YES

NO

K2a. An alcohol or drug detoxification unit to dry out for up to 72 hours?

1

2

K2b. An alcohol or drug program in which you live in a special facility or unit?

1

2

K2c. Drug or alcohol counseling with a trained professional while not living in a special facility or unit?

1

2

K2d. A self-help group or peer group counseling, such as Alcoholics Anonymous, Narcotics Anonymous, or Cocaine Anonymous?

1

2

K2e. An education or awareness program explaining problems with alcohol or drugs?

1

2

K2f. A program that provided a maintenance drug to cut your high or make you sick, such as methadone, antibuse, or naltrexone?

1

2

K2g. Some other alcohol or drug treatment program?

1

2


DO FOR x = a to g.

DEFINE PROGRAMX FILL

IF K2a = 1 THEN PROGRAMX = an alcohol or drug detoxification unit for up to 72 hours

IF K2b= 1 THEN PROGRAMX = an alcohol or drug program in which you lived in a special facility or unit

IF K2c = 1 THEN PROGRAMX = any drug or alcohol counseling with a trained professional while not living in a special facility or unit

IF K2d = 1 THEN PROGRAMX = a self-help group or peer counseling

IF K2e = 1 THEN PROGRAMX = an education or awareness program explaining problems with alcohol or drugs

IF K2f = 1 THEN PROGRAMX = a program that provided a maintenance drug to cut your high or make you sick

IF K2g = 1 THEN PROGRAMX = any other kind of alcohol or drug treatment program


K4x. [IF K2x = 1] Have you ever attended [PROGRAMX] while you were in jail, prison, or other correctional facility?


1 Yes

2 No

DK/REF


K6x. [IF K4x = 1] DOAFILL1, have you attended [PROGRAMX]?


1 Yes

2 No

DK/REF


K7x. [IF K6x = 1] Did you attend [PROGRAMX] for problems with alcohol, drugs, or both?


1 Alcohol only

2 Drugs only

3 Both alcohol and drugs

DK/REF


K8x. [IF K6x = 1] DOAFILL1, were you required to attend [PROGRAMX]?


1 Yes

2 No

DK/REF


K9x. [IF K6x = 1] Have you or will you receive any good or gain time by participating in [PROGRAMX] DOAFILL2?


1 Yes

2 No

DK/REF


K5x. [IF K2x = 1] Have you ever attended [PROGRAMX] while you were on probation or parole?


1 Yes

2 No

DK/REF


K10x. [IF K5x=1] When you were on probation or parole, were you required to attend [PROGRAMX]?


1 Yes

2 No

DK/REF


K11x. [IF K5x = 1] Did you attend [PROGRAMX] while you were on probation or parole for problems with alcohol, drugs, or both?


1 Alcohol only

2 Drugs only

3 Both alcohol and drugs

DK/REF




Section M: Interview Debriefing Items


TIME STAMP HERE


M0 Thank you for completing the survey. Now we have a few questions we’d like you to answer about your experience with this interview. Touch the NEXT button to go to the next screen.


M1 How difficult was it for you to use the computer to do this survey?


1 Not difficult at all

2 Sort of difficult

3 Very difficult

DK/REF


M2 How comfortable did you feel using the computer to answer questions about (your own experiences with sex and sexual assault in this facility / your use of drugs and alcohol)?


1 Very comfortable

2 Somewhat comfortable

3 Somewhat uncomfortable

4 Very uncomfortable

DK/REF


M3. How upsetting did you find it to answer questions about (your own experiences with sex and sexual assault in this facility / your use of drugs and alcohol)?


1 Not upsetting at all

2 Somewhat upsetting

3 Very upsetting

DK/REF


M4. [IF R RECEIVED SEXUAL ASSAULT QUESTIONS] Are there any types of sex or sexual contact that have happened to you DOAFILL1 that you didn’t report during this interview?


1 Yes

2 No

DK/REF


M5. How accurate are the answers you entered into the computer?


1 Not very accurate

2 Fairly accurate

3 Very accurate

DK/REF


MINC1 [IF I3 = 1] How important was knowing that you would receive a snack in appreciation of the time you spent completing this questionnaire?


1 Very important

2 Somewhat important

3 Not important

DK/REF



M6. That is all the questions we have.  If you found the survey questions upsetting for any reason, your interviewer can tell you how to contact a mental health counselor employed by this facility.  Thank you very much for participating in this study.


Please tell your interviewer that you have completed the survey.


M7. THANK INMATE FOR PARTICIPATING.


NOTIFY OFFICER THAT THE INMATE IS FINISHED AND CAN LEAVE THE INTERVIEW ROOM. AFTER THE INMATE LEAVES THE ROOM, ENTER THE PASSWORD TO CONTINUE ON TO YOUR DEBRIEFING QUESTIONS.


ENTER PASSWORD TO CONTINUE.


NOTE TO PROGRAMMER: WE’LL NEED A SHORT PASSWORD SO THAT RESPONDENTS CAN’T GO ANY FURTHER IN THE INTERVIEW. THE LAST SET OF DEBRIEFING QUESTIONS WILL BE FOR THE INTERVIEWER.


M8. Thank you for participating in this interview.


NOTIFY OFFICER THAT INMATE IS FINISHED AND CAN BE ESCORTED BACK TO HIS/HER CELL. ONCE THE INMATE HAS LEFT THE ROOM, TOUCH THE NEXT BUTTON TO GO TO THE NEXT SCREEN TO ANSWER DEBRIEFING QUESTIONS.


M9. Estimate the respondent’s understanding of the interview


1 No difficulty – no language or reading problem

2 Some difficulty

3 A great deal of difficulty


M10 How much do you think seeing or hearing about the laptop computer influenced the respondent’s decision to participate in the interview?


1 Influenced him/her a lot in a positive way

2 Influenced him/her a little in a positive way

3 Didn’t influence his/her decision at all

4 Influence him/her a little in a negative way

5 Influenced him/her a lot in a negative way


M11 Please indicate how necessary you think the tutorial was for this respondent.


1 Unnecessary – the respondent could have completed the interview without the tutorial

2 Useful, but perhaps not necessary – the tutorial made the ACASI portion easier, but the

respondent probably could have completed the interview without it

3 Necessary – the respondent could not have completed the ACASI portion without it


M12 Did the respondent raise any questions during the informed consent process?


1 Yes

2 No


M13 [IF M12 = 1] Please describe the questions the respondent raised during the informed consent process.


________________________________________________________________

ALLOW 150 CHARACTERS

M14 Please record any comments the respondent made about the nature of the questions or the task of answering the questions during either the CAPI or ACASI portions of the interview.


__________________________________________________________________

ALLOW 150 CHARACTERS


M15 How upset did the respondent appear to be during the ACASI portion of the interview?


1 Not upset at all

2 Somewhat upset

3 Very upset


M16 [IF M15 = 2 OR 3] Please provide any details you can about why this inmate appeared to be somewhat or very upset during the ACASI portion of the interview.


__________________________________________________________________

ALLOW 150 CHARACTERS


M17 Indicate the degree of distractions or interruptions during the interview.

1 None

2 A few

3 A lot


M18 Was the privacy of the interview setting compromised at any point during the interview?


1 Yes

2 No


M19 [IF M18 = 1] In what way was the privacy of the interview setting compromised during this interview?


________________________________________________________________

ALLOW 150 CHARACTERS


FIINC1 [IF I3 = 1] Did the inmate take the incentive that was offered?


  1. YES

  2. NO


FIINC2 [IF FIINC1 = 1] What incentive did the inmate receive?


_______________________________________________

ALLOW 40 CHARACTERS


M19a PLEASE PROVIDE ANY OTHER COMMENTS ABOUT THE INTERVIEW THAT WOULD BE USEFUL FOR THE PROJECT TEAM TO KNOW:


________________________________________________________________

ALLOW 150 CHARACTERS


FINAL TIME STAMP HERE


M20 INTERVIEWER: YOU HAVE REACHED THE END OF THE INTERVIEW. TOUCH THE FINISH BUTTON BELOW TO RETURN TO THE CASE MANAGEMENT SYSTEM.


Note to Programmers: Only two buttons are required for this screen – BACK and FINISH


17

Draft Specifications for Year 3

10% Sample

March 19, 2010

File Typeapplication/msword
File TitleSection 4: Sexual Activity Within the Facility
AuthorEmily McFarlane
Last Modified Bypricel
File Modified2010-07-02
File Created2010-07-02
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